Home' Trinidad and Tobago Guardian : March 26th 2013 Contents A36
body & soul
Guardian www.guardian.co.tt Tuesday, March 26, 2013
Dr Spencer King
a catheter is used
to repair a diseased
heart valve, at an
conference in San
problems that used
to require open-
heart surgery can
now be treated
SAN FRANCISCO---Have a heart problem? If it's
fixable, there's a good chance it can be done with-
out surgery, using tiny tools and devices that are
pushed through tubes into blood vessels.
Heart care is in the midst of a transformation.
Many problems that once required sawing through
the breastbone and opening up the chest for open
heart surgery can now be treated with a nip, twist
or patch through a tube.
These minimal procedures used to be done just
to unclog arteries and correct less common heart
rhythm problems. Now some patients are getting
such repairs for valves, irregular heartbeats, holes
in the heart and other defects---without major sur-
gery. Doctors even are testing ways to treat high
blood pressure with some of these new approach-
es.All rely on catheters---hollow tubes that let doctors
burn away and reshape heart tissue or correct defects
through small holes into blood vessels.
"This is the replacement for the surgeon's knife.
Instead of opening the chest, we're able to put
catheters in through the leg, sometimes through
the arm," said Dr Spencer King of St Joseph's Heart
and Vascular Institute in Atlanta. He is former pres-
ident of the American College of Cardiology.
Its conference earlier this month featured research
on these novel devices.
"Many patients after having this kind of procedure
in a day or two can go home" rather than staying
in the hospital while a big wound heals, he said.
It may lead to cheaper treatment, although the
initial cost of the novel devices often offsets the
savings from shorter hospital stays.
Not everyone can have catheter treatment, and
some promising devices have hit snags in testing.
Others on the market now are so new that it will
take several years to see if their results last as long
as the benefits from surgery do.
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.
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.
Here are some common problems and newer
treatments for them:
Millions of people have leaky heart valves. Each
year, more than 100,000 people in the US alone
have surgery for them. Just over a year ago, Edwards
Lifesciences Corp won approval to sell an artificial
aortic valve flexible and small enough to fit into a
catheter and be wedged inside a bad one.
Heart rhythm problems
Catheters can contain tools to vaporize or "ablate"
bits of heart tissue that cause abnormal signals that
control the heartbeat. This used to be done only
for some serious or relatively rare problems, or sur-
gically if a patient was having an operation for
another heart issue.
Now catheter ablation is being used for the most
common rhythm problem---atrial fibrillation, which
plagues about three million Americans and 15 million
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
The patch is also being tested for a more common
defect---PFO, a hole that results when the heart
wall doesn't seal the way it should after birth.
The original catheter-based treatment---balloon
angioplasty---is still used hundreds of thousands of
times each year in the US 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. (AP)
YOUR DAILY HEALTH
News and Advice
Heart repair breakthroughs
replace surgeon's knife
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