Device offers alternative to open heart surgery


Digging out a full-grown palm tree would be an accomplishment for any homeowner. But it's even more impressive when you realize that Jack Thorne recently underwent treatment for a heart condition, "I was just sitting, reading a newspaper on a Saturday morning and just all of a sudden I lurched forward twice," said Thorne.

It wasn't a heart attack, but a fairly common condition called mitral regurgitation. Basically, weakened valves in his heart were allowing blood to leak between chambers. Because of Thorne's age, doctors at El Camino Hospital in Mountain View recommended an experimental procedure using a device called the MitraClip.

"The real advantage is there's no sternotomy, so we're not cutting open the chest," Dr. Chad Rammohan said. "We're not stopping the heart, so no cardiac arrest."

Instead of an open chest surgery, Rammohan ran a catheter through a vein in Thorne's leg to reach the heart. Sophisticated imaging equipment provides a real-time view as the device is moved up through the catheter. Then Rammohan says the surgeons clip the valve flaps together, "Then we clip the anterior and posterior leaflets together so that they don't leak backwards. Still allows blood to flow forward, but not backwards."

The MitraClip is one of the two catheter-based heart devices now undergoing clinical trials at El Camino Hospital. While this procedure can offer certain advantages, Dr. Jim Joye notes there has also been resistance to the strategy from advocates of traditional heart surgery, "There's pressure because obviously the surgical community has been the heart and soul of this treatment for a long, long time. So there's resistance amongst some of those societies at this shift."

Joye is director of research at El Camino. He believes that the less-invasive catheter approach will become the preferred strategy for repairing heart valves within a decade, as new devices are approved.

Last year Edwards Lifesciences received approval for its heart valve replacement procedure for aortic stenosis. Also using a catheter, Abbott expects to meet with an FDA advisory panel later this year regarding approval of the MitraClip.

"Ultimately at the end of the day, it's about patients and patient welfare," Joye said. "And this new technology is life saving, it's much, much less invasive."

Thorne also experienced another advantage of the procedure -- being released from the hospital the next morning, far sooner than with an open chest surgery -- which put him back at home and back in his garden, "Because of that surgery, I haven't given up anything. I've spent a lot of time in the garden."

Abbott is currently planning a new round of clinical trials, looking at MitraClips' effectiveness on chronic heart patients who are consider too high-risk for surgery.

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