Balloon Valve May Be Alternative to Open-Heart Surgery

By Amanda Gardner
HealthDay Reporter
Monday, November 5, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

SUNDAY, Nov. 4 (HealthDay News) -- Older, high-risk heart patients with narrowed aortas who typically need open-heart surgery might someday have a new, less invasive option -- an implanted, balloon-expandable aortic valve.

The balloon is inserted percutaneously (through the skin), placed across the problem valve and then inflated, experts said. In a new study, the procedure -- not yet approved by the U.S. Food and Drug Administration -- showed real health benefits for up to two years.

The research is to be presented Sunday at the American Heart Association annual meeting in Orlando, Fla.

"The percutaneous balloon expandable aortic valve insertion provides a safe and sustained alternative for high-risk patients with severe aortic stenosis [closure]," said lead researcher Dr. Sanjeevan Pasupati, who was an interventional fellow at St. Paul's Hospital in Vancouver, British Columbia, when the study was conducted.

"In our first 100 high-risk patients, the intra procedural mortality was only 2 percent with minimal morbidity," Pasupati said. "Our long-term survival is promising, with 70 percent and 60 percent at one and two years, respectively. This procedure is here to stay."

Other experts stressed caution, however.

"This is a very exciting frontier for us in terms of being able to potentially fix these with percutaneous approach versus putting patients on a heart-lung machine," said Dr. John P. Erwin III, an associate professor of internal medicine at Texas A&M Health Science Center College of Medicine and a cardiologist with Scott & White Hospital in Temple. However, "this is still considered to be a high-risk procedure that is not quite ready for prime time at this point," he said.

According to the American Heart Association, aortic stenosis involves a blockage of the heart's aortic valve. The aorta is the body's main artery. The aortic valve closes over after each heartbeat to prevent blood from flowing back into the heart's left ventricle.

"Patients who have severe aortic stenosis and who may reach the criteria where they're best suited to have heart surgery often are very elderly and have other significant risk factors, so they're at high risk at the time they have open-heart surgery," Erwin explained. "There's a high prevalence of stroke and, in octogenarians, when we do bypass and place a valve, the combined mortality and major morbidity is about 25 percent."