Richard Kraus knew for a couple years that one of his heart valves
needed repair. When he began to feel winded from walking up the
small hill in front of his Stone Mountain home, Kraus' doctor told
him his heart's mitral valve was leaking and he would continue
to feel weakened until the problem was fixed.
Until
recently, his only course of treatment was open heart surgery,
a major procedure that could take several months of recovery time.
That is until he met Emory cardiologist Peter Block.
Block
performed the world's fifth nonsurgical repair of the mitral valve
on Kraus, 75, in early September at Emory Hospital. The innovative
procedure uses a catheter to attach a tiny metallic clip to a leaking
mitral valve, which separates the left upper and lower chambers
of the heart.
The
procedure may eliminate the need for open-heart surgery in some
patients, like Kraus, who suffer from significant mitral valve
regurgitation, a progressive, long-term disorder in
which the mitral valve does not close properly, causing the heart
to work harder as blood leaks backward. It affects some 4
million people in the United States, and about 250,000 develop
significant mitral regurgitation each year.
Patients
eventually become so weakened by the condition that they require
open-heart surgery to replace or repair the damaged mitral valve.
About 44,000 Americans undergo open-heart surgery annually for
mitral-valve repair.
The
new procedure is minimally invasive. Under full anesthesia, a catheter
(a thin, flexible plastic tube), introduced through the skin in
the thigh area, is guided through the femoral vein into the affected
area of the heart. A smaller delivery catheter that holds the implantable
clip is slipped through this tube, so the clip can be guided into
place and attached to the leaflets (the "swinging doors") of the
mitral valve. Once the clip is securely attached, the delivery
catheter is removed.
The
entire process is monitored by an echocardiogram, and patients
usually return to normal activity within a few days.
The
procedure is under an FDA-approved investigational device exemption
and has been performed on only five patients worldwide. It will
be under the FDA exemption through the 10th patient and then will
enter clinical trials.
"The
results are showing promise that open heart surgery will not be
the only option for patients suffering from mitral valve regurgitation," said
Block, professor of medicine. "There are many benefits--it is much
less invasive since it is done through a catheter, and recovery
time is quicker."
To
be eligible for the investigational procedure, candidates must
have moderate to severe mitral regurgitation and be experiencing
symptoms (fatigue, chest pain, shortness of breath); or, lacking
these symptoms, they must have a weakened left ventricle.
Before
his procedure, Kraus had to stop walking halfway up his driveway
to catch his breath. Today he can jog the small hill with no problems.
"This
was a good alternative for me," he said. "I am very happy I didn't
have to undergo open heart surgery, and the recovery time has been
short. I would recommend this to anyone." |