STUDY: Less Invasive Approach to Heart Valve Surgery May Be Better Option

"... this is the biggest change in heart care and cardiology over the past 15 years."

Fred Bodimer
March 22, 2019 - 9:47 am
ECG with a heart attack in hospital ward

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ST. LOUIS (KMOX) - Tens of thousands of cardiac patients may no longer need open heart surgery to replace a damaged aortic valve.

Up until now, aortic valves had to be surgically replaced unless you were at high-risk for not making it through open heart surgery.  In that case, the valve was replaced by inserting a new one through a catheter up an artery in the leg. 

Now, two new studies indicate a new procedure known as TAVR (transcatheter aortic valve replacement) works just as well in low-risk patients.

"Patients who would otherwise be deemed to be low-risk for having surgical aortic valve replacement were the focus of these studies," said SLU Care cardiologist Dr. Michael Lim at SSM Health Saint Louis University Hospital.  "So it was really challenging the catheter valves and saying, 'Are they actually as good or better than surgery?'  And it turns out the answer was a strongly definitive yes."

Dr. Lim attended last weekend's meeting of the American College of Cardiology in New Orleans where the results of these two studies were announced.

"Patients will have greater options for replacing an aortic valve," said Dr. Lim. "They will get the chance to choose between a catheter valve replacement and a surgical valve replacement."

And when it comes to treatment options, Dr. Lim says choice is a good thing.

"Any time you have a choice, it's a lot better when you're a patient," said Dr. Lim.

The new technique costs more upfront than surgery, but previous studies show the overall costs are lower because they require shorter hospital stays and cause fewer complications.

"The only caveat is that the FDA and the payment bodies have not endorsed the low-risk patient to have this aortic valve replacement by catheter, yet," said Dr. Lim. "But I would fully expect the strength of the data, based on these new studies, will be presented to the FDA and Medicare and other governing bodies and these things will happen relatively quickly throughout the course of 2019."

Dr. Lim says he's excited by the results of these two new studies.

"This is a phenomenal change in cardiovascular medicine," said Dr. Lim. "And in my opinion, this is the biggest change in heart care and cardiology over the past 15 years."