Safer heart valve replacement developed for high-risk patients

April 3 (UPI) — Researchers have developed a safer method for aortic valve replacement among high-risk patients, the National Institutes of Health announced.

Researchers with the NIH’s National, Heart, Lung and Blood Institute adopted the procedure during transcatheter aortic valve replacement, or TAVR. The method, called Bioprosthetic Aortic Scallop Intentional Laceration, was detailed in findings published Tuesday in the Journal of the American College of Cardiology: Cardiovascular Interventions.

Approximately 5 million people in the United States are diagnosed with heart valve disease, according to the American Heart Association. And an estimated 25,000 die each year, the AHA reported.

In aortic valve stenosis, the valve controlling blood leaving the heart narrows, resulting in shortness of breath, chest pain, blackouts and heart failure

Rather than performing open heart surgery among elderly or frail patients, TAVR involves threading a catheter, which is long, thin, flexible tube, through the femoral artery in the leg to the heart.

The surgery is risky. Some patients may develop coronary artery obstruction during the procedure — and more than half of them die.

“There is no good treatment or prevention strategy for TAVR-induced coronary obstruction,” Dr. Robert J. Lederman, the senior investigator in the NHLBI’s Division of Intramural Research, said in a press release. “The previous technique of using a stent to open the coronary artery appears to have poor long-term outcomes.”

Dr. Jaffar M. Khan of NHLBI developed the new technique, called BASILICA, which could make the procedure safer.

With BASILICA, the interventional cardiologist weaves an electrified wire about the size of a sewing thread through a catheter and splits the original leaflet in two. This prevents it from blocking the coronary artery once it has been pushed aside by the transcatheter heart valve.

Researchers said they successfully used the procedure in seven patients, who they qualified for the technique, which had previously not been tested in humans, because they had no alternatives available to them.

“All patients had a successful TAVR with no coronary obstruction, stroke or any major complication,” Lederman said. “They were doing well as they reached the 30-day-mark after the procedure.”

The NHLBI started enrolling patients in an early feasibility study of the technique earlier this year.

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