Procedure To Replace Heart Valve That Used To Be Reserved For Old, Sick Patients Can Work In Younger Ones Too
Surgery for certain bad heart valves may soon become a thing of the past. New studies suggest it can often be better to have a new valve placed through a tube into an artery instead. “Is it important? Heck, yes,” said Dr. Robert Lederman, who directs the interventional cardiology research program at the National Heart, Lung and Blood Institute. The findings “were remarkable,” he added.
The New York Times:
Tens Of Thousands Of Heart Patients May Not Need Open-Heart Surgery
The operation is a daring one: To replace a failing heart valve, cardiologists insert a replacement through a patient’s groin and thread it all the way to the heart, maneuvering it into the site of the old valve. The procedure, called transcatheter aortic valve replacement (TAVR), has been reserved mostly for patients so old and sick they might not survive open-heart surgery. Now, two large clinical trials show that TAVR is just as useful in younger, healthier patients. (Kolata, 3/16)
The Associated Press:
Newer Heart Valves May Let More People Avoid Surgery
A decade ago, expandable aortic valves were developed that can be guided to the heart through a catheter into a blood vessel and placed inside the old valve. But they're only used now in people at high or moderate risk of dying from surgery. The new studies tested these valves in people at low risk for the operation, as most patients are, and found them as good or superior to surgical ones. "This is our last frontier" to make these devices a standard of care, said Dr. Joseph Cleveland, a University of Colorado heart surgeon with no role in the studies or ties to the companies that sponsored them. "It's a great thing" for patients to be able to avoid major surgery, he said. (3/16)
The Wall Street Journal:
Smaller Hospitals Press For Chance To Offer Heart-Valve Procedure
TAVR has transformed treatment of certain heart-disease patients by giving them an alternative to open-heart surgery. Many of these patients are too sick to undergo the risks of open-heart surgery; yet patients undergoing TAVR also are at risk of complications, including stroke. To ensure safety, TAVR’s use has been effectively limited to bigger hospitals performing at least 20 of the procedures annually. That is because the federal Medicare health insurance program for the elderly, the biggest payer of TAVR bills in the U.S., has limited reimbursement to hospitals that would perform higher volumes of the procedures. (Loftus, 3/16)
