Niagara Gazette

Local News

March 24, 2013

Heart repair breakthroughs replace surgeon's knife

(Continued)

Niagara Gazette — But already, these procedures have allowed many people too old or frail for an operation to get help for problems that otherwise would likely kill them.

"You can do these on 90-year-old patients," King said.

These methods also offer an option for people who cannot tolerate long-term use of blood thinners or other drugs to manage their conditions, or who don't get enough help from these medicines and are getting worse.

"It's opened up a whole new field," said Dr. Hadley Wilson, cardiology chief at Carolinas HealthCare System in Charlotte. "We can hopefully treat more patients more definitively, with better results."

For patients, this is crucial: Make sure you are evaluated by a "heart team" that includes a surgeon as well as other specialists who do less invasive treatments. Many patients now get whatever treatment is offered by whatever specialist they are sent to, and those specialists sometimes are rivals.

"We want to get away from that" and do whatever is best for the patient, said Dr. Timothy Gardner, a surgeon at Christiana Care Health System in Newark, Del., and an American Heart Association spokesman. "There shouldn't be a rivalry in the field."

NEW TREATMENTS HEART VALVES -- Catheter-based treatments are in testing. One for the mitral valve -- Abbott Laboratories' MitraClip -- had a mixed review by federal Food and Drug Administration advisers this week; whether it will win FDA approval is unclear. It is already sold in Europe. HEART RHYTHM PROBLEMS -- Catheter ablation is being used for the most common rhythm problem -- atrial fibrillation, which plagues about 3 million Americans and 15 million people worldwide. HEART DEFECTS -- Some people have a hole in a heart wall called an atrial septal defect that causes abnormal blood flow. St. Jude Medical Inc.'s Amplatzer is a fabric-mesh patch threaded through catheters to plug the hole. CLOGGED ARTERIES -- The original catheter-based treatment -- balloon angioplasty -- is still used hundreds of thousands of times each year in the U.S. alone. A Japanese company, Terumo Corp., is one of the leaders of a new way to do it that is easier on patients -- through a catheter in the arm rather than the groin. Newer stents that prop arteries open and then dissolve over time, aimed at reducing the risk of blood clots, also are in late-stage testing. HIGH BLOOD PRESSURE -- About 75 million Americans and 1 billion people worldwide have high blood pressure, a major risk factor for heart attacks. Researchers are testing a possible long-term fix for dangerously high pressure that can't be controlled with multiple medications. It uses a catheter and radio waves to zap nerves, located near the kidneys, which fuel high blood pressure.

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