September 2007

 New Option for Heart Valve Replacement Under Study

Cardiothoracic surgeons Drs. Robert Guyton, Vinod Thourani, and Thomas Vassiliades recently began collaborating with interventional cardiologists Drs. Vasilis Babaliaros and Dr. Peter Block in a clinical trial comparing percutaneous aortic valve replacement with traditional, open-heart surgery or medical therapy in high-risk patients. The Emory-based group is the first in the Southeast and one of only five groups nationwide studying non-surgical treatment options for aortic stenosis, a condition that often occurs with age, leading to calcification or narrowing of the valve.

For more than 30 years, the standard therapy for aortic stenosis has been to remove the diseased valve through open-heart surgery. However, doctors are concerned that an open chest procedure has greater risk for complications and possibly death in patients with advanced age, end-stage disease, or other serious health concerns. Percutaneous aortic valve replacement provides a new option.

During the innovative procedure, a catheter carries a new aortic valve made of animal tissue sewn to the interior of a large stent. For delivery, the device is attached to the tip of a plastic catheter and compressed to the width of a pencil. The catheter is introduced through a small incision in the thigh or rib and is threaded toward the heart through the aorta. Pictures of the heart and aortic valve are obtained through ultrasound or x-ray and transmitted to the cardiologists for the duration of the procedure. Once the catheter is properly positioned in the opening of the aortic valve, the new valve is rapidly expanded, pushing the diseased, native valve aside. Blood then flows normally through the implanted valve to the rest of the body.

In 2002, the first percutaneous heart valve replacement was successfully implanted by French cardiologist Dr. Alain Cribier. Over the past few years, Dr. Babaliaros has worked with Dr. Cribier, learning the new approach and bringing his expertise back to the U.S. and to Emory.

Thus far, Drs. Babaliaros, Block, Guyton, Thourani, and Vassiliades have performed the percutaneous aortic valve replacement in two patients at Emory University Hospital. Both patients returned home within three days of the procedure.

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