Major improvement in aortic valve surgery with new procedure

Feb 12 2008

A study published recently in the Annals of Thoracic Surgery shows a 45% reduction in operative mortality in high risk patients requiring aortic valve replacement when Least Invasive Valve techniques are used compared to the conventional approach.

NYU surgeons Stephen B. Colvin and Aubrey C. Galloway developed the Least Invasive Valve “LiV” minimally invasive procedure to allow surgeons to safely and easily perform heart valve repair or replacement without the need for conventional open chest surgery. NYU surgeons have done more minimally invasive valve procedures than any other surgeons in the world.

The study used a measurement know as a “EuroScore” that establishes the risk level for each patient undergoing aortic valve replacement. Age and other health problems increase the patients EuroScore indicating a higher risk for complications or mortality. The group of patients in the study had EuroScores that put them in a high risk group, with a predicted operative risk of 17.2%, yet the actual observed operative risk was only 7.8%. The study further demonstrated that the LiV techniques used at NYU resulted in a 45% reduction in operative mortality compared with conventional surgery.

Aubrey Galloway, M.D., Seymour Cohn Professor & Chairman of Cardiothoracic Surgery at NYU Medical Center, stated, “The less invasive valve surgery techniques we have developed reduce complications and lower mortality risk in the highest risk groups requiring aortic valve replacement. In addition, least invasive surgical procedures can provide patients with a quicker recovery and faster return to normal activities.”

Lead author Eugene Grossi, M.D., Professor of Cardiothoracic Surgery and Director of Cardiac Surgical Research at NYU Medical Center, stated “percutaneous aortic valve replacement (PAVR) trials are ongoing in patients with elevated EuroSCOREs. These patients are believed to have high mortality rates and poor long-term prognoses with valve replacement surgery. We evaluated EuroSCORE prediction versus a single institution's surgical results in this target population; from January 1996 thru March 2006 in 731 patients with EuroSCOREs placing them in the high risk category. Our results clearly show that LiV Aortic Valve Replacement is currently the standard for aortic valve replacement. The hospital mortality was reduced by 45% using the LiV Procedure, and more importantly the freedom from all causes of death, including hospital mortality, was 72.4% at 5 years in this high risk group of patients. Clinical trials for using Percutaneous Valve Procedures for high risk aortic valve replacement must include randomized surgical controls and have long-term endpoints.”