- The Washington Times - Saturday, April 1, 2006


Dr. Samuel Lichtenstein cut a 2-inch hole between an elderly man’s ribs. Peering inside, he poked a pencil-sized wire up into the chest, piercing the bottom of the man’s heart.

Within minutes, Bud Boyer would have a new heart valve — without having his chest cracked open.

Call it closed-heart surgery.

“I consider it some kind of magic,” said Mr. Boyer, who left the Vancouver, British Columbia, hospital a day later and was almost fully recovered in just two weeks.

In Michigan, Dr. William O’Neill slipped an artificial valve through an even tinier opening. He pushed the valve up a patient’s leg artery until it lodged in just the right spot in the still-beating heart.

The dramatic experiments, in a few hospitals in the United States, Canada and Europe, are designed to find easier ways to replace diseased heart valves that threaten the lives of tens of thousands of people every year. The experiments are starting with the aortic valve that is the heart’s key doorway to the body.

The need for a less invasive alternative is great and growing. Already, about 50,000 people in the United States have open-heart surgery every year to replace the aortic valve. Surgeons saw the breastbone in half, stop the heart, cut out the old valve and sew in a new one. Even the best patients spend a week in the hospital and require two months or three months to recuperate.

Thousands more are turned away, deemed too ill to survive that operation and out of options. Demand is poised to skyrocket as the baby boomers gray — the aortic valve is particularly vulnerable to rusting shut with age.

The new experiments are a radical departure from that proven, if arduous, surgery.

The artificial valves do not even look like valves, squished inside metal cages until they are wedged into place. Barely 150 of any type have been implanted worldwide, most in the last year. It is not clear if they will work as well as traditional valve replacements, which last decades.

For now, the only patients who qualify for these valves are too sick to be good candidates for regular valve replacement.

Some deaths during the earliest attempts at implanting the devices forced doctors to come up with safer techniques. Clinical trials apparently are back on track, and even the most skeptical cardiologists and heart surgeons are watching how these pioneers fare.

The hope is that one day, replacing a heart valve could become almost an overnight procedure.

“There’s lots of technical challenges that need to be overcome,” said Dr. Robert Bonow, a valve specialist at Northwestern University who is monitoring the research for the American Heart Association. “Most of us do think this is the future,” he said.

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