University hospital fixing hearts without open-heart surgery

A screen shot from an animation provided to us by Oregon Health & Science University. »Play Video
This animation, provided to us by Oregon Health & Science University, shows the Medtronic valve-containing stent being inserted inside the human body.

PORTLAND, Ore. – The pediatric cardiac team at Oregon Health & Science University Doernbecher Children’s Hospital is the first in the region and one of a handful in the nation to implant a pulmonary heart valve without open-heart surgery, the hospital reports Wednesday.

“The remarkable thing about this procedure is that the valve is placed into the beating heart through a vein in the patient’s leg," said Laurie Armsby, M.D., associate professor of pediatric cardiology at OHSU Doernbecher and Burch’s partner in the OHSU Pediatric and Adult Congenital Cardiac Catheterization Lab. "After the procedure, patients spend a night on the hospital ward and are discharged home the following morning.”

To date, four patients have received the landmark valve in the OHSU Pediatric and Adult Congenital Cardiac Catheterization Lab. And all, according to OHSU, "reported immediate improvement in their energy level and stamina."

Replacing open-heart surgery
?
The device, called the Medtronic Melody Transcatheter Pulmonary Valve, was approved just recently by the Food and Drug Administration. The valve replaces any narrow or leaky pulmonary valve “conduits” – tubes connecting the heart to the lungs – in children or adults who've previously undergone corrective congenital heart defect surgery.

"Until now," hospital officials report, "pulmonary valve replacements have required open-heart surgery."

The Melody valve is inserted into a tiny opening in the leg and guided by a catheter through blood vessels into the heart. Once the valve is correctly positioned, a balloon on the end of the catheter is inflated, delivering the valve and immediately correcting blood flow.

Or at least a "safe and effective" alternative

“Children born with blocked or leaky heart valves can undergo as many as four open-heart surgeries before reaching adulthood to replace conduits that have worn out or that they’ve outgrown, and each time the risk of surgery goes up,” said Grant Burch, M.D., director of the OHSU Pediatric and Adult Congenital Cardiac Catheterization Lab and associate professor of pediatric cardiology at OHSU Doernbecher Children’s Hospital. “The Melody extends the useful life of an implanted valve conduit and is very likely to reduce the number of open-heart operations a patient might require over a lifetime.”

One of the first four patients to receive the new Melody valve at OHSU Wednesday, and the hospital has provided us with an animated video of the procedure and photos of the valve.

“This device is not going to abolish the need for open-heart surgery," Burch said, "but it does provide a safe and effective alternative to surgery for many children and young adults with congenital heart disease.”


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