Open heart surgery—without ‘open’ or ‘surgery’

Open heart surgery—without ‘open’ or ‘surgery’

Although most people may never have heard of aortic valve stenosis (AS), this condition afflicts an estimated 7 percent of the population 65 and older. Left untreated, symptomatic AS carries with it a significantly worse survival rate than metastatic breast, lung, colon and prostate cancers.

AS is the narrowing (stenosis) of the aortic valve, which restricts the flow of blood from your heart’s left ventricle to the entire body. The narrowing may be present at birth, or acquired over time as a result of rheumatic fever or radiation therapy. But most cases are directly related to aging, as calcium accumulates within the valve’s leaflets.

Over time, these leaflets become stiff, reducing their ability to fully open and close. As a result, the heart must work harder to overcome the restriction.

In most cases, severe AS has required open heart surgery to replace the diseased valve. Unfortunately, a growing number of patients are poor candidates for the surgery because of their overall frail health or other health complications that make the procedure too risky.

For many, that meant a virtual death sentence. Half of inoperable severe AS patients will die within one year and nearly 70 percent within two years, said Richard Zelman, MD, director of Interventional Cardiology at Cape Cod and Falmouth hospitals.

Today, that dismal prognosis is changing rapidly with the emergence of a new technology and procedure available to the sickest and highest-risk patients on Cape Cod and elsewhere.

Transcatheter Aortic Valve Replacement, or TAVR, avoids the trauma of surgically opening the chest, dividing the breastbone and replacing the damaged aortic valve with a mechanical or biological one.

TAVR surgeons, known as “interventionalists,” enter non-invasively through a small needle hole, usually at the upper leg. They place a sheath, which is a small hollow tube the diameter of a pencil, in the femoral artery.

Guided by X-ray and ultrasound technology, the doctors then insert a catheter tube with a balloon on its end across the diseased valve. They briefly inflate the balloon to make room for the new valve to be inserted and expanded inside the old one.

9 comments on “Open heart surgery—without ‘open’ or ‘surgery’
  1. Elizabeth Simons says:

    Good news!

  2. Denny O'Neil says:

    Nice to know it is available, especially since I cannot have the regular “open” procedure(due to three thoracic surgeries leaving me with missing ribs and a pleuradectomy). Thank you. Denny O’Neil

  3. Ann Olim Bruni says:

    May Dr.Zelman be blessed and live forever. Thank you Dr. Zelman for saving my life and being so kind. You will always be my hero. Ann

  4. J Doane says:

    I am immensely impressed by CCHC cardiac doctors. I appreciate that Dr Zelman continues to educate himself in order to give Cape Codders the best treatments available in the world. Thank you very much Dr Zelman.

  5. Richard Gibson says:

    I still don’t understand…..how and where does “the incision” take place? I’m possibly going to be a candidate for aortic valve replacement (not sure if necessary yet?) was told it would be “the old way” where chest is opened etc. scared the hell out of me! Being a “Laryngectomy” I am very concerned about being “under” for any long period of time.

  6. Marjorie Travers says:

    Is this a bloodless procedure?

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A BIG thank you to Big Nick's Ride for the Fallen and the generous donation to the Cape Cod Healthcare Blood Center!

A BIG thank you to Big Nick's Ride for the Fallen and the generous donation to the Cape Cod Healthcare Blood Center!