Replacing heart valves with a still-beating heart
April 21, 2008
Interventional cardiologists at Rush Univ. Medical Center now offer a minimally invasive transcatheter valve replacement procedure for patients with congenital heart disease that doesn't involve open heart surgery.
Rush is one of three sites taking part in the investigational device exemption (IDE) feasibility study of minimally invasive pulmonic valves and successfully implanted the first three patients enrolled in the trial on April 17.
"We were able to successfully implant the Edwards SAPIEN transcatheter heart valve percutaneously in the first three patients treated in this trial. All of the patients are recovering and are expected to go home," said Ziyad M. Hijazi, director of the Rush Center for Congenital and Structural Heart Disease, chief of the section of pediatric cardiology and professor in the departments of pediatrics and internal medicine at Rush Univ., Chicago. "Patients with congenital right ventricular outflow tract problems typically face the burden of multiple open-heart surgeries throughout their lives, either to replace their 'native' diseased valves or, as they age, their bioprosthetic replacement valves.”
Hijazi, an interventional cardiologist and pioneer in nonsurgical repair of the heart, and his colleagues, Clifford J. Kavinsky and Zahid Amin, used a bovine pericardial heart valve that can be compressed onto a balloon to the approximate diameter of a pencil, threaded from the leg into the circulatory system and deployed across the patient's pulmonary valve. The valve replacement is accomplished as a "beating heart" procedure, without requiring cardiopulmonary bypass or an open-chest incision.
Edwards Lifesciences Corporation of Irvine, Calif., makes the Edwards SAPIEN transcatheter valve that was implanted.
"We can replace heart valves in high-risk patients with severe pulmonary stenosis (abnormal narrowing in a blood vessel) who might not be candidates for conventional valve replacement surgery. Instead, these patients can benefit from a transcatheter valve replacement procedure done minimally-invasively, without cardio-pulmonary bypass, that has the potential to shorten recovery time," says Hijazi.
"Patients with congenital right ventricular outflow tract problems typically face the burden of multiple open-heart surgeries throughout their lives, either to replace their 'native' diseased valves or, as they age, their bioprosthetic valves. This clinical study will enable physicians to offer a minimally-invasive alternative to symptomatic patients with a regurgitant, or leaky, pulmonary valve conduit, giving them the opportunity to recover and resume their normal activities."
"My team is proud to be able to address this serious unmet patient need and to offer the chance to take one or more surgeries out of the treatment course for these patients," says Hijazi.
The U.S. Food and Drug Administration (FDA) conditionally approved the investigational device exemption (IDE) clinical trial in late 2007. The study of 30 patients at three hospitals will enable the collection of safety and effectiveness data, ultimately in support of a commercial approval application.
Edwards' physician partners performed the first U.S. transcatheter pulmonic case on a compassionate basis in December 2005, and have performed a total of five compassionate cases in Canada & the U.S. All of the patients were successfully treated.
The Edwards SAPIEN transcatheter heart valve is also currently being studied in the PARTNER (Placement of AoRTic traNscathetER valves) U.S. pivotal trial for the treatment of patients with severe aortic heart valve stenosis (a narrowing of the aortic valve that restricts blood flow), who are considered to be high risk for conventional open-heart valve replacement surgery.
Rush Univ. Medical Center: http://www.rush.edu
Edwards Lifesciences: http://www.edwards.com/products/percutaneousvalves/sapienthv.htm
SOURCES: Rush Univ. Medical Center; Edwards Lifesciences
Interventional cardiologists at Rush Univ. Medical Center now offer a minimally invasive transcatheter valve replacement procedure for patients with congenital heart disease that doesn't involve open heart surgery.
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"We were able to successfully implant the Edwards SAPIEN transcatheter heart valve percutaneously in the first three patients treated in this trial. All of the patients are recovering and are expected to go home," said Ziyad M. Hijazi, director of the Rush Center for Congenital and Structural Heart Disease, chief of the section of pediatric cardiology and professor in the departments of pediatrics and internal medicine at Rush Univ., Chicago. "Patients with congenital right ventricular outflow tract problems typically face the burden of multiple open-heart surgeries throughout their lives, either to replace their 'native' diseased valves or, as they age, their bioprosthetic replacement valves.”
Hijazi, an interventional cardiologist and pioneer in nonsurgical repair of the heart, and his colleagues, Clifford J. Kavinsky and Zahid Amin, used a bovine pericardial heart valve that can be compressed onto a balloon to the approximate diameter of a pencil, threaded from the leg into the circulatory system and deployed across the patient's pulmonary valve. The valve replacement is accomplished as a "beating heart" procedure, without requiring cardiopulmonary bypass or an open-chest incision.
Edwards Lifesciences Corporation of Irvine, Calif., makes the Edwards SAPIEN transcatheter valve that was implanted.
"We can replace heart valves in high-risk patients with severe pulmonary stenosis (abnormal narrowing in a blood vessel) who might not be candidates for conventional valve replacement surgery. Instead, these patients can benefit from a transcatheter valve replacement procedure done minimally-invasively, without cardio-pulmonary bypass, that has the potential to shorten recovery time," says Hijazi.
"Patients with congenital right ventricular outflow tract problems typically face the burden of multiple open-heart surgeries throughout their lives, either to replace their 'native' diseased valves or, as they age, their bioprosthetic valves. This clinical study will enable physicians to offer a minimally-invasive alternative to symptomatic patients with a regurgitant, or leaky, pulmonary valve conduit, giving them the opportunity to recover and resume their normal activities."
"My team is proud to be able to address this serious unmet patient need and to offer the chance to take one or more surgeries out of the treatment course for these patients," says Hijazi.
|
Edwards' physician partners performed the first U.S. transcatheter pulmonic case on a compassionate basis in December 2005, and have performed a total of five compassionate cases in Canada & the U.S. All of the patients were successfully treated.
The Edwards SAPIEN transcatheter heart valve is also currently being studied in the PARTNER (Placement of AoRTic traNscathetER valves) U.S. pivotal trial for the treatment of patients with severe aortic heart valve stenosis (a narrowing of the aortic valve that restricts blood flow), who are considered to be high risk for conventional open-heart valve replacement surgery.
Rush Univ. Medical Center: http://www.rush.edu
Edwards Lifesciences: http://www.edwards.com/products/percutaneousvalves/sapienthv.htm
SOURCES: Rush Univ. Medical Center; Edwards Lifesciences
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