As many of you know, I’m fascinated with technology.

That said, when I’m invited to see a clinical application of a new heart valve technology, I jump at the opportunity. So, last week, I found myself in a hybrid catheterization laboratory / operating suite at the University of Virginia in Charlottesville, Virginia. Dr. Scott Lim, Associate Professor of Pediatrics and Medicine, Division of Cardiology, was performing a MitraClip procedure.

Dr. Scott Lim, M.D. And Me (Adam)

“We’ve been investigating the MitraClip therapy in select patients as an alternative, less-invasive therapy for mitral regurgitation,” Dr. Lim shared with me. “By clipping the mitral leaflets into a double-orifice configuration we can reduce leakage across the valve – without inducing stenosis.”

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Interest in catheter-based technologies for heart valve repair and heart valve replacement continues to skyrocket.

As you have seen, we recently (i) reviewed new data for the SAPIEN aortic valve replacement and (ii) observed a MitraClip case for mitral valve repair. Recently, I learned that Medtronic, one of the leading heart valve manufacturers, received FDA approval for its investigational device exemption application. That means that Medtronic can conduct a patient trial to determine the safety and efficacy of its percutaneous CoreValve system for aortic valve replacement.

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As technology for heart valve treatment rapidly advances, we continue to learn more about the roll-out of percutaneous devices for both heart valve repair and heart valve replacement. On Tuesday, Medtronic announced that regulators in the European Union have approved the latest version of its CoreValve heart system.

The CoreValve delivery system is designed to help surgeons replace a diseased aortic valve without removing the original valve and without open heart surgery. Instead, they put a new valve into a catheter and guide the catheter to the heart from an artery in the leg.

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Recently, I was extremely lucky to observe Dr. Saibal Kar and his team perform its 103rd MitraClip procedure on a patient with severe mitral regurgitation at Cedars-Sinai Hospital in Los Angeles, California.

Dr. Saibal Kar And Me In The Cath Lab At Cedars-Sinai

While I expected to watch the procedure from a gallery – much like an episode of Grey’s Anatomy – I quickly found myself inside the cardiac catheter lab wearing scrubs and a lead suit used to protect me against x-ray exposure from fluoroscopy.

For the next three hours, I had front-row access to Dr. Saibal Kar’s team as they cared for the patient and deployed the new MitraClip device. Yes… This was much, much, much better than an episode of Grey’s Anatomy.

Although the MitraClip has yet to receive FDA approval in the United States, Dr. Kar has been using the device to treat mitral valve regurgitation without causing any physical trauma to the patient’s sternum or ribs. As previously discussed, the results of the MitraClip clinical trials have been encouraging.

A few minutes before the procedure began, I was very surprised to see a familiar face enter the cardiac catheterization lab. Doctor Alfredo Trento, the Chief of Cardiothoracic Surgery at Cedars-Sinai Hospital, quietly assumed a position to left of Dr. Kar.

Dr. Kar (Cardiologist) and Dr. Trento (Cardiac Surgeon)
Work Side-By-Side During A MitraClip Procedure

“This has got to be somewhat unique,” I thought to myself, “Given the distinct nature of their specialties and some of the skepticism surrounding the MitraClip from the surgeon community, I can not imagine this is common.” (I would later learn that, so far, only a handful of cardiac surgeons have taken a serious clinical interest in this non-invasive procedure used to treat mitral valve regurgitation.)

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This is an exciting time for the medical treatment of diseased heart valves. As demonstrated in prior blogs, unique technologies are rapidly evolving to correct heart valve disorders including aortic stenosis and mitral regurgitation. That said, conversations specific to minimally invasive heart valve procedures often stimulate exciting clinical and patient possibilities.

Dr. Husam Balkhy – Chairman of Cardiac Surgery,
The Wisconsin Heart Hospital

On this note, I recently had the opportunity to interview Dr. Husam Balkhy, Chairman of Cardiac Surgery at The Wisconsin Heart Hospital. As you may remember, Dr. Balkhy has been intimately involved in the adaptive use of the Da Vinci surgical robot for aortic valve replacement surgery.

If you are interested in learning more about the current and future use of robotics for aortic valve replacement, please read the interview notes provided below:

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