Heart Valve Disease and Technology

Published 06/28/11


The heart beats more than two billion times over the course of a lifetime...and sometimes fails!


Man 1: This is the sound of a healthy heart. It beats more than 2 billion times over the course of a lifetime. Man 2: A heart is a pump and its job is to pump blood forward to your body. Like all pumps, it has valves that keep the blood from flowing backwards. Man 1: Four chambers work in rhythm to transport blood throughout the body. As each chamber contracts, valves open and close, moving blood in and out. When valves fail, so can the heart. Man 2: The most common heart valve diseases are those related to the aortic valve and the mitral valve. As we get older, are more likely to have a problem with one of our heart valves. You can think of them as simply wearing out. Man 1: There are no medicines to treat heart valves. Man 2: Eventually, if a valve disease progresses and becomes severe, the only present available treatment is surgery. Man 1: Either valve repair... Man 2: Repairs imply leaving in most of the native valve in the heart, and working on the valve itself. Man 1: ...or replacement. Man 2: Valve replacement, of course, means that we take out the patient's own diseased valve, and replace it with another valve. Man 1: One option is a biologic valve made of heart tissue from pigs and cows. They have some advantages. Man 2: The tissue valves generally don't require long-term anti- coagulation. Man 1: Which means patients would not need to take a blood thinner, like Coumadin. But these tissue valves have a limited lifespan of ten to 15 years. Man 2: Patients who are very young, looking to avoid a second heart operation will typically choose a mechanical valve. Man 1: Mechanical valves come with a lifetime prescription for blood thinners. Man 2: We're always balancing the risk of too much Coumadin which causes bleeding complications. But if you take too little, you're at risk for clots forming on your mechanical valve. Man 1: Advances in heart valve technology look to change that. Man 3: We're determining whether you can use no Coumadin in certain patients or lower Coumadin in others. Man 1: Clinical trials are now wrapping up in the U.S. following promising overseas trials looking at whether a specific type of mechanical valve, called the Onyx valve, can reduce or eliminate the need for Coumadin. Man 2: The smoother the surface on the mechanical valve, the less likely blood is to clot on it. Man 1: That smoother surface comes from a purified carbon that doesn't contain silicone like in older valves. Also, specially designed pivots keep blood from stagnating. Man 2: The flow through the valve is smoother, less turbulent, produces less likelihood of clotting. Man 1: Gary Peterson is part of the clinical trial. His does of Coumadin has been replaced with less potent blood thinners, Plavix and aspirin. Now, Gary is always on the go. Gary: I do ten to 12k's on weekends, and then I also do some swing and ballroom dancing. Man 1: Valve replacement usually requires open heart surgery, which is risky for older patients. Man 2: Their age alone will give you a very, very high mortality. Man 1: That was the case for veteran Girl Scout, Mary Anne Cahallen. Mary Ann: I was starting to tell people, don't call on me for this program or that program, because I don't think I'll be there. Man 1: Until she underwent an experimental, minimally invasive procedure to replace her aortic valve. Man 2: I believe that this is a monumental breakthrough. Man 1: A catheter is inserted through a small incision in the groin. Then a biologic valve sewn to a metal stint is fed through the catheter, and into the heart, where it pushes a faulty valve aside and takes its place. Man 2: We're seeing a very low complication rate, much lower than what would be seen in surgery, and such a short recovery time that they don't have an opportunity to develop a lot of the postoperative complications that one might see. Man 1: Within days, she was back on her feet, and soon after that, back at Scout Camp. Mary Ann: I had no trouble walking from the lodge to the dining hall and back again. Man 1: New valves and a change of heart for those who have them.

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