Heart Surgery Breakthrough: Lifesaver for Seniors

Wednesday, 11 Sep 2013 09:58 AM

By John Bachman and Nick Tate

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William O'Neill, M.D., knew that his 79-year-old heart patient was running out of options. She desperately needed a new heart valve but was too frail for conventional surgery. In a world-first, Dr. O'Neill and his colleagues at Henry Ford Hospital in Detroit created a new way to implant the valve, and the patient came through the procedure with flying colors.
 
Now, Dr. O'Neill says the pioneering surgery could save thousands of other seniors who have been considered too weak for open-heart surgery.
 
"Since it's not a traditional procedure, we're really offering it only to people who have no other options and we're being very careful," Dr. O'Neill tells Newsmax Health. "Having said that, we've already seen six patients that were candidates and we've treated five others, again, with very good success. So we're going to be continuing to do this and we're going to invite other centers around the county to learn how to do the procedure."
 
Story continues below video.
 

 
About 5 million Americans are diagnosed with heart valve disease every year, notes Dr. O'Neill, a medical director at the Center for Structural Heart Disease at Henry Ford Hospital. Of those, tens of thousands undergo surgery for a condition called "aortic stenosis" — a narrowing of the aortic valve that causes it to stay closed.
 
But the new technique Dr. O'Neill helped pioneer offers an alternative approach that could help many of those individuals who aren't good candidates for open-heart surgery. The technique builds on a new approach known as a "transcaval" procedure, which involves threading a guide wire through a vein —typically through the leg — and passing it into the main artery of the body, the abdominal aorta. Then the openings of the vein and artery are gradually widened to allow a catheter to continue to the heart and implant the new artificial valve, according to Henry Ford officials.
 
SPECIAL: These 4 Things Happen Right Before a Heart Attack — Read More.

The catheter is then removed and plugs are inserted in the artery and the vein to close the holes made for the temporary connection of the two major blood vessels.
 
Dr. O'Neill estimates that this new procedure could help 25,000-50,000 patients a year in the U.S. But for many women, the blood vessels in the legs are too small for the procedure to work.
 
"They're probably about 150,000 aortic valve operations a year that are being done — open heart operations," he explains. "Many of those patients now can be treated with these nonsurgical valves except that, in particular, in women, the blood vessels in the legs are too small to allow the catheters to go up. So that's where I estimate that anywhere between [25,000] and 50,000 people a year in the U.S., and probably double that number in the rest of the world, could be treated with this new technique. "
 
The 79-year-old heart patient he recently treated with the technique had previously had surgery to implant a pig valve and it worked fine for many years. But unfortunately, the tissue started to fall apart and the patient was deteriorating rapidly.
 
"There are other techniques of being able to fix it — perhaps open-heart operations again — but she wasn't eligible," Dr. O'Neill says. "And so she was in our recovery room and deteriorating every day and so we came up with a new technique for being able to put the valve in by a new method of crossing from the main vein in the stomach across to the aorta and then putting the valve up into the heart through the aorta and repairing it. It's never been done before in humans and has actually worked very dramatically and very successfully."
 
Dr. O'Neill credits an associate with actually suggesting the technique.
 
"I won't take the credit for the idea," he says. "A colleague of ours in Washington wrote an article in one of the cardiology journals where they've done some animal experiments to show that it was possible in animals and so there was some background idea that it could work. And so we just took that idea that had previously been tested in the basic laboratory and brought it to the patients. It was basically an emergency procedure and we explained to the patient and her family that there really wasn't any other option."
 
He adds that his patient has been "doing great" since the procedure.
 
"It's just really been dramatic. She was in the hospital for a few days to recuperate and then she went home to Northern Michigan and … everything is healing. All of the lines and everything that were put in are all gone. The hole that we made in the aorta is now fully healed and we expect that she's got 15 years of good quality of life added to her life now. "
 
Dr. O'Neill predicts the procedure could become more commonly available within five years.
 
"Medicine is very conservative," he notes. "Breakthroughs like these actually take quite a bit of time to translate into other centers. We plan on working with the government to establish a formal registry so that we can keep track of how this is going. And it will probably take two to five years before it's more widely available."

SPECIAL: These 4 Things Happen Right Before a Heart Attack — Read More.

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