Review of percutaneous valve therapy

Researchers at TCT 2007, the annual scientific symposium of the Cardiovascular Research Foundation (CRF), will present new studies evaluating a rapidly advancing field within interventional cardiology: percutaneous procedures to repair and replace defective heart valves.

Percutaneous valve procedures, which are currently approved only in Europe, are under study in the U.S. In particular, researchers are studying the safety and effectiveness of the devices being used and the techniques used to implant them, as well as the profile of patients who should receive them.

Several studies analyzing the safety and efficacy of percutaneous valve therapies will be presented at TCT 2007:

• High-risk patients receive life-saving valve replacement
  In a study of 85 patients at high-risk for surgery with stenotic aortic valves, scientists led by John Webb, MD, FACP(C) and Sanjeevan Pasupati, MBChB, FRACP of St. Paul's Hospital, Vancouver, BC, Canada, describe the first-in-man implantations of the transarterial Percutaneous Aortic Valve (PAV). In these patients, transarterial PAV implantation produced clinical improvements that were sustained at 1 year.
• Aortic valve replacement
  A team led by Susheel Kodali, MD, of Columbia University, New York, NY, reported mid-term results from the U.S. transcather aortic valve replacement experience. Between December 2005 and November 2006, 55 patients were enrolled. The team concluded that in high-surgical-risk patients, percutaneous aortic valve replacement provides sustained symptom improvement for at least 6-12 months. One-year survival (72.8%) was limited primarily by pre-existing conditions unrelated to the valve implant in this high-risk population.
• Successful left ventricle remodeling with new percutaneous valve device
  Mitral insufficiency (abnormal blood leakage from the left ventricle through the mitral valve into the left atrium), when severe, may lead to progressive left ventricular enlargement and heart failure. Repair of the leaking mitral valve may improve the function of the failing heart (reverse LV remodeling). A device known as the Mitra Clip was found to be effective, demonstrating significant clinical improvements in patients with mitral regurgitation who had Charlotte, NC.

In addition to these presentations, panel discussions were held on Sunday October 21, “Percutaneous Mitral Valve Repair and Replacement,” led by Ted Feldman, MD, Northwestern University, Feinberg School of Medicine. These panels discussed the various types of and approaches.