Breakthrough in keyhole heart valve replacement

[sanuk711]

In a world-first breakthrough, Macquarie University researchers

have developed a reliably safe and effective way to perform keyhole

heart valve replacement surgery, even for the most high-risk patients.

21/10/2021

 

 

Something that interests me--because I have shyed off of having open heart for some years, cutting through the Breast plate etc.---they do have a few places (surgeons) in BKK that can do Trans catheter  surgery, (brake a rib go in through the side) but this new advancement from Oz leaves that all behind ---Having Heart valve replacement through the groin, under local anesthetic (awake) and being discharged within a day or so of the opp .

Australia is one of the leading countries for heart perorations--- If, You can afford it. Or- If you can afford the wait.

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https://lighthouse.mq.edu.au/article/october-2021/breakthrough-in-keyhole-heart-valve-replacement

 

Cardiovascular disease remains the number one cause of death worldwide. Aortic stenosis – the narrowing of the valve that controls blood flow from the heart – is one of the most common heart valve diseases, with up to one in eight older Australians affected.

 

It is also the most serious. Without surgery, about half of all people with severe aortic stenosis will die within two years.

One of the greatest advances in the treatment of heart disease this century has been the development of transcatheter aortic valve implantation, or TAVI, to treat aortic stenosis.

Instead of performing open heart surgery, a cardiologist introduces a new valve usually through an artery in the groin and then moves it to the heart. Once the new valve is in place, it is expanded.

Leading interventional cardiologist Professor Martin Ng, a pioneer in minimally invasive heart valve treatments, has led a ground-breaking research program to significantly improve TAVI by addressing its key limitations.

A perfect fit

“TAVI has changed millions of people’s lives, because instead of having major surgery and taking weeks to recover, you can have this minimally invasive procedure and go home one or two days later,” he said.

“Unfortunately, there are limits. The replacement valve needs to fit exactly once expanded.

“If the new valve is not expanded enough, the patient ends up with paravalvular leak, which is the biggest contributor to long-term mortality following TAVI. If the valve is expanded too much, it ruptures the aorta, and if that happens, the patient dies on the table. There is nothing we can do to save them.

“Until now, nobody knew how to determine the correct pressure to achieve that perfect fit.”

TAVI can now be safely performed even for the highest-risk patients such as those with a build-up of calcium that has hardened the aorta.

Building on the research of the late Professor Geoffrey White, the founding professor of vascular surgery at Macquarie University Hospital, Professor Ng worked with colleagues including Dr Afik Snir, who has a background in biomedical engineering, heart valve imaging specialist Dr Chris Naoum, and engineers at the University of Sydney to determine the ‘sweet spot’ for inflating the valve.

They used the Law of Laplace, which governs tension in the walls of containers – such as heart valves – to work out the correct thresholds.

“These findings represent five years of work, and are the first time anyone has been able to determine the correct pressure to deploy the valves every time,” Professor Ng said.

“Once the cardiologist choses the size of the replacement valve, we can reliably tell them the right pressure to expand it to minimise the chance of paravalvular leak while also protecting the aorta from rupture.

[scubascuba3]

That is good news, my mum had heart valve surgery a few years ago, biiiiiiiig op