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Is Open Heart Surgery still Necessary? New Study Says There May Be Better Alternatives


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11/21/2014
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Heart disease is one of the leading causes of death amongst American men and women. Many Americans go through grueling and expensive open heart surgery in order to save their lives. But one group of researchers say that this might be unnecessary.

CBS news reports on an alternative to open heart surgery.

An innovative group of surgeons have started doing aortic valve replacements instead of open heart surgery. This type of procedure has less of a recovery period and less expense.

Dr. Kodali is one of the doctors who find that aortic replacement is a better option for many than open heart surgery. He is currently a cardiac surgeon operating out of New York-Presbyterian/Columbia University Medical Center's Heart Valve Center.  

While helping a patient Dr. Kodali said to CBS, “You see, one of the keys to this procedure is imaging, because we're not opening the chest, so we use all modalities available including X-Ray and echo.”

How often are transcatheter aortic valve replacement (TAVR) procedures performed?

Thousands have actually been done already. For example, Dr. Kodali and his team have performed more than 1,200 transcatheter aortic valve replacement (TAVR) procedures just like the one he described since the FDA approved TAVR three years ago.

What exactly is an aortic valve replacement and why should your physician be presenting it as an option? It is a non-invasive alternative to heart surgery. What happens in it?

Surgeons replace the aortic valve, responsible for pumping blood out of the heart, via a narrow tube called a catheter. The catheter is enlarged using a balloon structure, similar to a heart stent, and through it a replacement valve is fitted into that position. This procedure is more cost efficient and has a shorter recovery period for patients.

What are some more benefits of TAVR?

“Because TAVR does not stop the heart or require putting the patient on a heart-lung bypass machine, it's made treatment for aortic valve conditions accessible to thousands of patients, mostly elderly, who would otherwise have been deemed ‘too risky’ for open heart surgery and left with no other options. And compared to open heart surgery, the recovery period after TAVR is much less difficult,” according to CBS.

Dr. Kodali and many other specialists find that TAVR should replace open heart surgery (for most patients). He finds that this is a much better option for all patients concerned. The first TAVR procedure was actually done twelve years ago in France. The procedure was first started in the United States in 2005 at Columbia’s medical center.

Dr. Kodali says, “Surgery is great but it's not improving, for the most part they've perfected what they can do. But now, with TAVR, we're just at the infancy, it's within 10 years and such a rapid rate of iteration... I think we'll be doing it in a large majority of patients that need valve replacement.”

Aortic stenosis is the most common disease of older heart patients.

But what exactly is aortic stenosis?

Aortic stenosis is the narrowing of the aortic valve opening. In the United States it affects around 300,000 people, and many need a heart valve replacement. If it is left untreated then severe symptomatic aortic stenosis carries a poor prognosis; up to 60 percent of patients will die within 2 years, and less than 30 percent will survive around 3 years.

TAVR does not extract the old, failing valve. All it does is displaces it within the heart and replaces it with a new valve, which is much more simple. Surgeons are developing techniques that will minimize the likelihood of problems arising from the old valve remaining in the heart.

Another expert in the field told CBS more about the benefits associated with TAVR saying,

“The low rates of stroke and valve leakage with the CoreValve System - two of the most concerning complications of valve replacement because they increase the risk of death and have a dramatic impact on quality of life - set a new standard for transcatheter valves.”

 



Category: Misdiagnosis and Failure to Diagnose


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