May 23, 2011

Noninvasive Mitral Valve Repair May Not be Getting a Fair Shot

Posted in Heart Disease in the News, Helpful Heart Links, New Heart Studies, Uncategorized tagged , , , , , , , , , , at 12:00 pm by keepyourhearthealthy

MitraClip Mitral Valve Repair System.

from the Abbott website

MedPage Today reported promising results in a study yesterday involving noninvasive mitral valve repair.  Some clinicians feel the results could be much better if the patient population were different.

A new device called the MitraClip is getting significant publicity after initial results of the Everest II study were recently released.  The MitraClip is a small prosthesis used to treat severe Mitral Regurgitation (a condition in which too much blood is going through the mitral valve in the wrong direction).  This noninvasive repair process  invloves implanting the clip onto the mitral valve of the heart by a simple needlestick in the groin.

The procedure is very similar to a heart catheterization for placing stents in which a wire is guided up through a blood vessel into the heart.  According to the manufacturer’s website (Abbott), “The Guide Catheter is inserted into the femoral vein at the groin and provides access to the mitral valve. The Clip is used to grasp and fasten together the valve leaflets.”  Once the clip is holding the mitral valve together in the middle, the valve is no longer able to allow so much blood to flow backwards.  There is still plenty of flow forward around the clip.

The new study Everest II which is testing this device in up to 47 sites throughout the US and Canada has reported that “quality of life, and rates of re-hospitalization for heart failure improved significantly in the MitraClip-treated patients at one year” according to MedPage Today’s article.  This was determined only after they compared “high-risk” surgical candidates.  According to Bob Baeten, PA-C, at Piedmont Hospital in Atlanta, the new methodology for testing this device may be preventing it from getting better results.  He states, “We’re testing this on the sickest of the sick rather than the patients who could recover easily from surgery.  It’s the patients who get turned down for surgery that are tested with the MitraClip.  These people are already very ill which is why they were turned down for surgery in the first place.”

It should be noted that the MitraClip has been approved and used commercially in Europe for 3 years now.  The device is still seeking approval here in the U.S.  The only way an American citizen can obtain this noninvasive mitral valve repair currently is by entering into a study at participating study locations.

For more information about heart catheterization procedures and recovering from heart surgery, check out the book What To Do When You Have Heart Disease at Amazon.com.

September 29, 2010

Robotically Assisted Ballon Angioplasty and Stent Placement

Posted in Heart Disease in the News, New Heart Studies tagged , , , , , , at 12:20 am by keepyourhearthealthy

photo by Filomena Scalise

You may have heard of robotically assisted bypass surgery but now there are even more complex machines placing stents in people.

Robotics in a medical setting help to create more precise cuts and movements.  For bypass surgery, robotically assisted open heart has been rumored to create smaller incisions.  The first case of robotically assisted stent placement was reported last week in Washington, DC.

Undergoing a heart stent procedure does not involve large cuts by any means.  There is only a small needlestick in the groin area.  So, how can robotics help in a situation like this?  First, it helps your cardiologist live more comfortably.  When the cardiologist is placing a stent, they are exposed to radiation from the x-rays needed to see where the heart arteries are.  They also must wear a very heavy lead apron to avoid overexposure of radiation to their body.  Robotics can also be helpful with stents by making placement of the stent to certain areas more accurate.  A cardiologist can use a joystick to make the tiniest movements of the catheter and stent.

The technology is still a long way off but I wouldn’t be surprised if this becomes much more popular over the next 20 years…assuming we haven’t found a cure for heart disease by then!

September 25, 2010

The Most Minimally Invasive Aortic Valve Replacement

Posted in Heart Disease in the News, Heart disease tips, Helpful Heart Links, New Heart Studies tagged , , , , , , , , , , at 12:21 am by keepyourhearthealthy

photo by jscreationzs

Aortic Stenosis Fixed With A Poke Of The Needle?

From my earlier post you will see that there have been several new advances reported this week in cardiology.  The biggest one by far is a study called TAVI or Transcatheter Aortic Valve Implantation.  This new study has reported some great results with implanting a brand new aortic valve through a simple needlestick during a heart catheterization.

As people get older, the aortic valve frequently becomes hard and narrowed.  This condition is called aortic stenosis.  Aortic stenosis is considered severe when the valve area is less than 1cm².  Greater than 4% of patients over age 85 have aortic stenosis but unfortunately they are considered a poor candidate for traditional open heart surgery to replace the valve by that age. A recent option for older patients has been balloon angioplasty of the valve by heart catheterization but this gives poor results and adds less than a year of optimal results.

The new TAVI study has shown that a prosthetic aortic valve can actually be placed safely over the old, hardened valve by a simple needlestick during heart catheterization.  The results of the study show significant improvement in valve function and much fewer deaths one year after the procedure.  To see a video of this type of procedure, check out the following link:

http://wn.com/Edwards_Sapien_Transcatheter_Heart_Valve

September 11, 2010

The Report That Lets You Shop Around For Bypass Surgery

Posted in Heart Disease in the News, Helpful Heart Links tagged , , , , , , , , , , at 6:01 pm by keepyourhearthealthy

http://fmp.cit.nih.gov/hi/ Title: Coronary art...

Image via Wikipedia

The decision to undergo bypass is a major ordeal for many heart disease patients.

The thought of having your chest cut open and then possibly not waking up is frightening!  Luckily, the risk of death and complications are usually quite small with most surgeons performing bypass surgery.  However, you should check out your options for both surgeons and hospitals if you want the absolute best outcome.

A report published in Consumer Reports Health has listed out the ratings of over 200 cardiothoracic surgeon groups in the US.  The information was compiled by the Society of Thoracic Surgeons and all surgeons had to agree to have their information published.  With approximately 1100 groups giving information for the entire study, that means only 20% of them were motivated enough to allow their ratings to be published.

The ratings were given on a scale of one to three stars (one being the worst and three being the best).  The number of stars were based on 30-day survival, surgical technique, complications associated with the bypass and appropriate medications prescribed.

In case you are thinking that your regular subscription to Consumer Reports will let you see THIS particular report on their Consumer Reports Health website…not so!  I already tried it myself.  I logged in to consumerreports.org and they still advised me to get a subscription to the Health portion before viewing the actual results.  However, according to theheart.org, 50 of the programs received the highest rating and 5 received the lowest.   Given that publishing the results was voluntary, it makes you wonder why those 5 cardiothoracic surgery groups chose to publish their results?  They could have opted out like 900 other groups did!

In case you are shopping around for the ultimate bypass surgeon and are interested in viewing the report, here is the link to a sneak peek with the option to log in or subscribe:

Consumer Reports Health Bypass Surgery Ratings