Game changers: New ways to save hearts

"To me, each time it's done, it's like a miracle," said Robert Segal of Cedars Sinai Hospital.

Even doctors are in awe that heart valves can now be replaced without open heart surgery. Now patients with heart valve problems can go from having one that’s 85 years old, to having a valve that’s brand new within an hour at the lab.

Retired meat cutter Will Neighbors avoided going under the knife himself after he was diagnosed with Aortic Valve Stenosis. His heart valve was calcified, hardening and failing. Duke cardiologists replaced his old valve with a new pig valve, delivered on the end of a catheter through a groin artery to the heart.

"These are perfect,” Segal said of the fresh valves. “It looks like a child's aortic valve."

Neighbors is one of the first to get a same-day coronary angioplasty, where tiny balloons are inflated into the blocked arteries. Traditionally, cardiologists access the heart by threading a catheter through an artery in the leg. Now they've changed their approach, starting at the wrist. The risk of bleeding is less and patients can go home the same day.

For some, stents are life-savers to keep arteries open. Now, a new stent could do job then dissolve away. "The vessel needs to be supported for 3 to 4 months, said Interventional Cardiologist Stephen Ellis. “After that it heals to the point where it's no longer at risk for the collapse."

On traditional stents, there's a high risk of blood clots forming on the stent, setting off a heart attack. At just 41 years old, Willi Hampton knows the danger.

"It started to feel heavy. Like someone was sitting on my chest," he said.

That heaviness ended in stroke. Doctors hope patients like him will benefit from the absorbable stents. They provide support to blood vessels, release anti-scarring medication, and then disappear.

"The goal is to make this sort of stent the gold standard," said Ellis.

Keeping hearts beating better-and longer.

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RESEARCH SUMMARY

BACKGROUND: Heart disease is a term used to describe a range of diseases that affect your heart. The various diseases include those of blood vessels, such as coronary artery disease; heart rhythm problems (arrhythmias); heart infections; and heart defects you're born with (congenital heart defects). The term "heart disease" is often used interchangeably with "cardiovascular disease." Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as infections and conditions that affect your heart's muscle, valves or beating rhythm, also are considered forms of heart disease. (www.mayoclinic.com)

PREVENTION: Certain types of heart disease, such as heart defects, can't be prevented. However, you can help prevent many other types of heart disease by making lifestyle changes such as:
* Quit smoking
* Control other health conditions, such as high blood pressure, high cholesterol and diabetes
* Exercise at least 30 minutes a day on most days of the week
* Eat a diet that's low in salt and saturated fat
* Maintain a healthy weight
* Reduce and manage stress
* Practice good hygiene (www.mayoclinic.com)
GAME CHANGING TREATMENTS:
1. TAVI: An investigational treatment for severe aortic stenosis in which an artificial aortic heart valve, attached to a wire frame, is guided by catheter to the heart. Once in the proper position, the wire frame expands allowing the new valve to open and begin to pump blood. CoreValve Clinical trials are being sponsored by Medtronic. (www.medtronic.com)
2. Radial artery angioplasty: Doctors at Henry Ford Hospital are using a new technique for cardiac catheterization that causes less bleeding and shortens recovery time. The technique uses the radial artery in the wrist to gain access to the heart. Most U.S. doctors still use the femoral artery technique, but the radial artery technique is slowly gaining acceptance because of its safety and patient convenience advantages. (www.henryford.com)
3. Absorbable Stents: ABSORB by Abbott is the first device of its kind to treat coronary artery disease. It dissolves in approximately two years. Since a permanent metallic implant is not left behind, naturally occurring vessel functions can be restored. In January 2011, Europe approved ABSORB for use. It is still under development in the U.S. (www.abbott.com)
FOR MORE INFORMATION, PLEASE CONTACT:

Adam Greenbaum, MD
Director, Cardiac Catheterization Laboratory
Henry Ford Hospital
(313) 916-3875
agreenb1@hfhs.org

Tora Vinci
Media Relations
Cleveland Clinic
(216)444 -2412
vinciv@ccf.org

Debbe Geiger
Senior Media Relations Officer
Duke Medicine Office of News and Communications
Debbe.Geiger@duke.edu
(919) 660 -9461

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marsha Hitchcock at mhitchcock@ivanhoe.com.


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