New Procedure for Patients at High Risk for Severe Heart Failure

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Bob Hallinan

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      A team of physician-researchers at the University of Kansas Medical Center is testing a new procedure that replaces a leaky mitral heart valve for people at high risk for heart failure but too frail or ill for open heart surgery. The procedure is part of the APOLLO clinical trial.

     Of the heart’s four valves, the mitral valve is the one most commonly in need of repair or replacement, yet it often goes untreated when patients are not able to withstand open-heart surgery. The new procedure, known as transcatheter mitral valve replacement (TMVR), provides an alternative to conventional open-heart surgery, a more invasive operation that takes months to recover from.  

     Unlike open-heart surgery, TMVR does not require putting patients on bypass or making a long incision down the chest. Instead, the team makes an incision three inches long between the ribs and inserts a delivery tube the width of a Sharpie into the heart. That tube contains a compressed replacement valve. The physicians then expand the new valve within the malfunctioning mitral valve.

     The procedure takes about two hours, compared to up to six hours for open heart surgery, and recovery is just two to three weeks.

     So far, the KU team has performed the TMVR procedure successfully on three study participants. “There’s a huge unmet need for something like this,” said Mark Wiley, M.D., chair of the Department of Cardiovascular Medicine at the University of Kansas School of Medicine and a co-principal investigator on the study. “I believe it is really going to change our approach to heart valve replacement.”

       In this video, Dr. Wiley provides some more details about how the procedure works and what it can mean for cardiac patients. The video also shows Dr. Mark Wiley and Dr. Emmanuel Daon, two of the physicians who do the procedure, in the operating room.