Out of Options: New Valve Saves Hearts


CLEVELAND, Ohio (Ivanhoe Newswire) — Tricuspid valve regurgitation is a heart condition that affects about one million Americans. It can lead to heart failure that’s difficult to treat. Now, the first patient in the world is getting a brand new device for patients who have run out of options.

A few months ago, 78-year-old Edward Liebler thought he was out of options. Edward’s heart was failing and he’d already had four surgeries to fix it.

“Eventually, I began to deteriorate again. Oh, I could hardly walk from one end of my house to the other,” Liebler told Ivanhoe.

Liebler had a condition called tricuspid valve regurgitation. His right heart valve was leaking, causing blood to pump backwards. The problem was so bad that another major surgery was out of the question.

Jose Navia, MD, Cardiothoracic Surgeon at the Cleveland Clinic said, “He was really, really at the end of life, actually. So, there’s no other option for him to, you know, fix the problem.”

But doctors at the Cleveland Clinic offered him one last hope … a new type of valve replacement under development. Liebler became the first patient in the world to receive the device after the FDA allowed it for compassionate use. Doctors implanted the valve through the jugular vein in Liebler’s neck. The new valve replaced his old, leaky valve.

“Right now, the valve is competent, all the blood is going to the normal direction, forward, not backward,” Dr. Navia continued.

This procedure only required a small incision in the neck. Recovery was only a couple of days in the hospital compared to at least ten days with traditional open-heart surgery. For Liebler, it was a last-ditch effort that saved his life.

Dr. Navia shared, “It was a really, really good result for him.”

“I really feel quite good right now,” said Liebler.

The new device has been used on seven more patients. Right now, this technology is only being used in high-risk patients who are too sick for traditional surgery, but doctors hope to test it on heart patients who aren’t high-risk in the future.

Contributors to this news report include: John Cherry and Julie Marks, Producers; Roque Correa, Editor.

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REPORT #2510

BACKGROUND: According to the American Heart Association, about 5 million Americans are diagnosed with heart valve disease each year. The four heart valves make sure that blood always flows freely in a forward direction and that there is no backward leakage. Blood flows from your right and left atria into your ventricles through the open tricuspid and mitral valves. When the ventricles are full, the tricuspid and mitral valves shut. This prevents blood from flowing backward into the atria while the ventricles contract. As the ventricles begin to contract, the pulmonic and aortic valves are forced open and blood is pumped out of the ventricles. When the ventricles finish contracting and begin to relax, the aortic and pulmonic valves shut. These valves prevent blood from flowing back into the ventricles. Heart valve disease can develop before birth (congenital) or can be acquired sometime during one’s lifetime. Sometimes, the cause of valve disease is unknown.

(Source: https://www.webmd.com/heart-disease/guide/heart-valve-disease#1)

SYMPTOMS OF SEVERE HEART DISEASE: Tricuspid regurgitation is leakage of blood backwards through the tricuspid valve each time the right ventricle contracts. As the right ventricle contracts to pump blood forward to the lungs, some blood leaks backward into the right atrium, increasing the volume of blood in the atrium. As a result, the right atrium can enlarge, which can change the pressure in the nearby chambers and blood vessels. Tricuspid regurgitation may not have any symptoms or the symptoms may be vague, such as weakness and fatigue, which develop because the heart is not pumping enough blood to allow the body to receive the needed oxygen. Other symptoms may include active pulsing in the neck veins, enlarged liver, fatigue or weakness, abdominal swelling, swelling in the legs, ankles, and/or feet. Treatment may not be required if the symptoms are not bothersome. Surgical valve repair or valve replacement usually cures the condition, but those with untreated, severe tricuspid regurgitation may face a poor prognosis, either from the valve disease itself or because of the complications from the underlying condition causing the valve problem.

(Source: http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Problem-Tricuspid-Valve-Regurgitation_UCM_450617_Article.jsp#.Wl4gmI3bLcs)

ALTERNATIVE TREATMENT: Tricuspid valve therapy is a safe and feasible treatment alternative for patients with severe symptomatic tricuspid regurgitation, according to the results of two trials presented at the 2017 Transcatheter Cardiovascular Therapeutics meeting. The two studies investigated the device performance of transcatheter therapy systems in patients with severe tricuspid regurgitation. “Treatment alternatives for patients with severe symptomatic tricuspid regurgitation are limited. Medical therapy is often ineffective and surgery is associated with high operative mortality,” Martin B. Leon, MD, director of the Center for Interventional Vascular Therapy at Columbia University Medical Center at NewYork-Presbyterian Hospital, said. “Less-invasive transcatheter therapies designed to reduce tricuspid regurgitation offer the potential to improve clinical outcomes.”

(Source: https://www.healio.com/cardiac-vascular-intervention/structural/news/online/%7Be4a28162-4cb3-4c9c-b1ba-2c35e77c9071%7D/new-transcatheter-devices-show-promise-in-severe-secondary-tricuspid-regurgitation)

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