BLOODLESS HEART SURGERY WITH NO TISSUE OR BONE CUTTING IS TODAY ALMOST THE STANDARD

 Remember when chest surgery, no matter what the problem, involved cutting open the chest and ribs with a saw and spreading them to get at the heart? Well in most cases now this is a thing of the past. But there is a unique approach being experimented with that is actually “bloodless” and quite miraculous. In this case it is valve repair or replacement.

The mitral valve is a one-way valve that connects the left atrium to the left ventricle of the heart. With mitral valve problem, the valve does not seal completely and blood leaks back into the left atrium. This reverse flow can cause the heart and lungs to swell. Symptoms may include an audible heart murmur, shortness of breath, and heart palpitations.

Four million Americans are estimated to suffer from mitral valve problems, with nearly 250,000 Americans diagnosed each year. In turn, approximately 40,000 Americans undergo surgery for mitral valve regurgitation annually, according to the Society of Thoracic Surgeons. For most patients, traditional mitral valve repair requires an invasive procedure called a sternotomy, they undergo heart bypass, and have their valve repaired or replaced with a tissue or mechanical substitute. They typically remain three to five days in the hospital and experience a lengthy recovery period at home. Nationally, patients undergoing mitral valve surgery face a 2.3 percent mortality rate for repair and 5.6 percent for replacement.

With this miraculous operation the cardiologist guides a catheter, or thin tube, through the vascular system to the heart's mitral valve, using fluoroscopic and echocardiographic imaging to show the way. The repair replacement, on the tip of the catheter, is then placed on the center of the valve leaflets, holding them together. The heart beats normally throughout the procedure.

This new valve is part of the natural evolution of mitral valve repair for regurgitation—from open heart surgery to minimally invasive approaches to robotic repairs and now a non-surgical solution, says Allan Schwartz, MD, Harold Ames Hatch Professor of Medicine and Chief, Division of Cardiology, Department of Medicine, Columbia University College of Physicians & Surgeons, is a huge leap forward for us.

Where the techniques will take these pioneers is anyone’s guess. But for the tens of thousands who suffer from this and other internal ailments, the future is bright.