Healthy Living: Heart valve surgery
In the U.S. each year, approximately 50,000 people undergo open-heart surgery to replace a heart valve. Marcie Fraser takes a look at the risks.
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Heart surgery carries risk, especially for those who have other medical problems.
"Particularly elderly patients that have a variety of other illnesses. A very weak heart, bad lung disease, dialysis or badly kidney function typically do not tolerate open heart procedures," said Dr. Augustin DeLago, Interventional Cardiologist.
No options until this past November, when the FDA approved trans-catheter aortic valve replacement or called TAVR. It allows for valve replacement without open-heart surgery.
"The length of the stay in hospital was less than traditionally surgery, they are up and about and the lifestyle improved quicker," said Dr. DeLago.
This minimally invasive alternative involves delivering a collapsible artificial valve into the heart using a catheter inserted through a small incision in an artery of the leg. The artificial valve device is clamped onto a balloon, this balloon is passed up through the major blood vessel of the heart called the aorta. It is then is placed across the valve and then the balloon is expanded, wedging the artificial valve in place. Every surgery has risks, some more than others.
"We are dealing with very ill patients to begin with, so the stroke rate can be significant. You can tear the heart or the aorta itself. We have surgeons standing by but if those complications happen during the procedure, the mortality can be significant,” said Dr. DeLago.
Because the procedure is less invasive and less traumatic for the patient, recuperation is also made easier.
"One of the out of two die because of the disease process. If we able implant a valve like this, we drop mortality by thirty percent,” said Dr. DeLago.
While the procedure is still new and there are questions about how durable the stent is, the future looks very good.
“There are ongoing studies, these patients are being followed and once we have more data on durability, you will see expanded likely it’s a use of less traumatic transplant of the aortic valve,” said Dr. DeLago.