REPAIRING LEAKY HEARTS
About four million Americans have a problem called mitral valve regurgitation. The condition can be dangerous and even deadly if it's not fixed. Now, doctors are testing a treatment that's correcting the problem without major surgery.
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A walk in the park is something Trevor Gatty doesn't take for granted these days. Before having a leaky heart valve repaired, this simple stroll would have left him exhausted.
Trevor Gatty,
Had leaky heart valve
"I used to walk to the store, and by the time I got back, I felt quite knackered."
Doctor Michael Rinaldi says Trevor's condition caused blood to leak backward, while the heart tried to pump it forward.
Michael Rinaldi, MD
Interventional Cardiologist
Carolinas Medical Center
Charlotte, NC
"When that valve becomes leaky, the heart can actually fail. It can stop pumping well and that manifests itself as trouble breathing, heart failure and can eventually lead to death."
Mitral valve leaks are usually treated with open heart surgery. But Trevor took part in a clinical trial testing an experimental procedure that only requires a small incision in the groin.
Michael Rinaldi, MD
"Using ultrasound guidance, we're able to actually grab the two leaflets of that valve and clip them together with this new small device."
Once the clip is in place, blood flows normally. The new approach reduces the risk of complications, decreases pain and dramatically shortens recovery time.
Michael Rinaldi, MD
"We've been very excited with the results. Three quarters of the patients are being helped, and that's fantastic when there was no alternative before."
For Trevor, the benefits were clear almost immediately.
Trevor Gatty
"About two weeks after the surgery, I suddenly found myself marching as though I was back in the army marching around the parade ground, just walking briskly and enjoying it."
And now he can enjoy all of life's simple pleasures.
So far, 80 people have been treated with the new procedure. Typically, recovery from standard open heart surgery is one month. With this procedure, it's just a few days. Right now, the only way to have the new procedure is at one of the 25 sites around the country that are participating in the trial.
BACKGROUND: About 4 million American have a condition called mitral valve regurgitation. It's a condition in which the mitral valve doesn't close tightly, which allows blood to flow backward in the heart. When the mitral valve doesn't function properly, blood can't move through the heart or to the rest of the body as efficiently. Mitral valve regurgitation is also called mitral insufficiency, or incompetence. The condition can leave you fatigued and short of breath. As many as one in five people over age 55 have some degree of mitral valve regurgitation. Mitral regurgitation is the most common type of heart valve insufficiency. Any disorder that weakens or damages this valve can prevent it from closing properly, causing this type of leakage. Mitral regurgitation becomes chronic when the condition persists rather than occurring for only a short time period.
TREATMENT: Hospitalization may be required for treatment of severe symptoms. Surgical repair or replacement of the valve is recommended if heart function is poor, if symptoms are severe, or if the condition deteriorates. Medications that regulate the heart rhythm may be needed to control irregular rhythms as well as drugs that dilate blood vessels to reduce the workload of the heart. Replacing a valve or repairing a valve often requires major surgery. While the procedures are highly successful, open-heart surgery always takes a toll on the patient. A stay in an intensive care unit for the first two or three days following the operation is usually required. Heart functions will be monitored constantly. The average hospital stay is one week to two weeks. Complete recovery will take a few weeks to several months, depending on the health of the patient before surgery.
NEW TREATMENT: An experimental procedure may one day be available to patients with mitral valve regurgitation. Instead of opening the chest to directly access the heart, surgeons operate through a tiny incision in the thigh. Surgeons at Sanger Clinic in Charlotte, N.C., performed the experimental procedure as part of clinical trials. Using ultrasound guidance, the physicians snake a catheter through blood vessels and into the heart. Using a tiny clip, called the Mitraclip, they fasten the two leaflets of the valve together. The clip allows blood to flow normally through the heart. The new procedure decreases pain and dramatically shortens the amount of recovery time. So far, surgeons have treated 80 people with the experimental procedure. About 10 and 20 percent have experienced complications. Compare that to 25 percent of patients who have complications with standard open surgery. Right now, the only way to get the new procedure is at one of the 25 sites around the country participating in the clinical trials.
CLINICAL TRIALS: If you want to know more information about the procedure and which medical centers are part of the clinical trials, go to: www.mitralregurgitation.org/Pages/EVEREST.html
Sanger Clinic
1001 Blythe Boulevard
Charlotte, NC 28203
(704) 373-0212
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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