News | June 08, 2009

Percutaneous Value Replacement is an Option for Elderly Who May Not Survive Open-Heart Surgery

June 8, 2009 - Patients unable to undergo open-heart surgery may be candidates for a new nonsurgical aortic valve replacement procedure, according to a study presented at the 20th Annual Scientific Sessions of the American Society of Echocardiography (ASE) being held this week in Washington, D.C..

Transcatheter aortic valve replacement is a promising new treatment for patients with severe aortic stenosis who are considered high-risk for conventional surgical aortic valve replacement. With this approach, echocardiography, or heart ultrasound, is used to guide interventional cardiologists through the procedure and to assess the effects of intervention after the procedure. While this study showed promising results, the FDA has not yet approved transcatheter procedures for aortic valve replacement.

“Some people with severe aortic stenosis, or narrowing of the aortic valve, are not good candidates for open-heart surgery, because they may have other medical conditions that would classify them as high risk for surgery,” said Dr. Linda D. Gillam of the Columbia University Medical Center in New York, a lead author on the study. “This less invasive approach proved to be as effective as surgical aortic valve replacement with the patients in the study and can be done in a cath lab with less stress to the patient and a shorter recovery period.”

A total of 24 patients with symptomatic aortic stenosis underwent successful transcatheter aortic valve replacement or surgical aortic valve replacement during the study. There were no significant baseline differences between the two approaches. The study concluded that transcatheter and surgical aortic valve replacement result in comparable improvements in radial strain, strain rate and left ventricular ejection fraction in elderly patients with severe symptomatic aortic stenosis.

“People in their 80s have a 5-10 percent mortality rate when undergoing surgery for aortic valve replacement,” Gillam said. “These findings are especially critical for elderly patients who could not survive open-heart surgery.”

The study was conducted by Kotaro Arai, Eiichi Hyodo, Rebecca T. Hahn, Weihong Li, Kohei Fujimoto, Roy Pizzarello, Susheel Kodali, Mathew Williams, Martin B. Leon, Shunichi Homma, and Linda D. Gillam at Columbia University Medical Center in New York, NY.

The American Society of Echocardiography (ASE) is a professional organization of physicians, cardiac sonographers, nurses and scientists involved in echocardiography, the use of ultrasound to image the heart and cardiovascular system.

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