Developments in Brief : Balloons Used to Open Heart Valves
Researchers last week reported more encouraging results in using balloons to squeeze open damaged heart valves, a procedure that someday may replace open-heart surgery for thousands of people.
The technique, tested during the last year on several hundred patients around the world, opens up heart valves that are narrowed by the results of rheumatic fever, birth defects or degeneration in old age.
Valve damage interferes with the flow of blood, forcing the heart to pump harder to maintain circulation. When it falls behind, victims suffer swelling, shortness of breath and other symptoms of heart failure.
In the new procedure, called percutaneous balloon valvuloplasty, doctors insert a catheter into a vein or artery and use it to maneuver a small balloon into the heart. There the balloon is inflated, forcing open the narrow valve.
The mitral valve controls the flow of blood into the left ventricle, the heart’s main pumping chamber. Rheumatic fever is the chief cause of narrowing of the mitral valve.
If percutaneous balloon valvuloplasty continues to work as well as they hope, it eventually could be done in a day on an outpatient basis, the researchers say. The alternative is fixing or replacing the damaged valve surgically, which requires 10 or 12 days of hospitalization, plus weeks of recuperation.
The procedure was pioneered by French physicians, who have performed it on more than 500 patients. The latest results of their experience and that of three other teams based in Boston, were presented at the annual meeting of the American College of Cardiology in New Orleans.
At Massachusetts General Hospital, 75 people with mitral valve stenosis have been treated, and all of them improved, with 65% to 70% reporting excellent results.
The procedure’s future is less clear in the treatment of narrowing of the aortic valve, which allows blood to flow into the aorta, the body’s main artery. This condition is primarily seen among the elderly.
“It may be fantastic, or the application of it may be very limited. Which of those two describes the future of this procedure will depend on the follow-up results in these patients,” said Dr. Jeffrey M. Isner of the New England Medical Center.
