As life expectancy increases, it is not uncommon for patients in their 80s and 90s to need heart procedures, said Dr. Les Walters, an interventional cardiologist at University Hospital who is helping to implement the structural heart program.
“And yet how do you treat them?” he said. “They’re certainly at high risk for surgery.”
Perhaps 30 percent are either too medically fragile for surgery or would be at high risk, Walters said.
In January, University is planning to begin offering a procedure called transcatheter aortic valve replacement. A catheter is threaded through a hole in the leg up an artery to the aortic valve in the heart; the compressed replacement valve is passed up over a balloon on the catheter into the opening; the balloon opens up to press the valve into place; then the balloon is removed and the valve remains, Walters said.
“It’s really quite amazing what you can do without having to cut someone open,” he said.
While the procedure and equipment were created in the United States, the first procedure was done in France, and it has spread to other countries because it is easier to implement things there, Walters said.
The company, Edwards Lifesciences, limits the program to places such as University that do a lot of procedures. University is putting together a team of almost 40 to do this and other minimally invasive heart procedures, he said.
“It’s a huge hospitalwide endeavor to bring these (procedures) on board,” Walters said.
The structural heart program brings together a wide variety of heart expertise, from cardiologists to cardiothoracic surgeons, vascular surgeons, anesthesiologists, and catheter lab and operating room teams, he said.
“A lot of these things now are really complex, and we’re doing a lot of things with this team approach,” Walters said. “We’re bringing all of the people in that area to fix it that have any expertise and are working together to come up with the best solutions.”
The new techniques will be expanded to other heart conditions and repairs, and this new approach is opening a “whole new arena” for patients, he said.
“This is one of those big sea changes in cardiology,” he said. “It’s really trying to treat these high-risk patients in a low-risk fashion and prolong life and relieve symptoms.”