Minimally invasive alternative to open heart surgery

A new minimally invasive treatment for patients with aortic valve stenosis, a form of valvular heart disease, could provide hope for patients who are categorised as too high-risk for conventional open heart surgery. The new treatment, transcatheter aortic valve implantation (TAVI) is being offered by Consultant Cardiologist Dr Simon Kennon at BMI The London Independent Hospital and could help save hundreds of lives each year.

Aortic valve stenosis is a thickening and stiffening of the aortic valve resulting in narrowing of the opening that sits at the junction between the heart and the main artery that carries blood around the body. The narrowing of the aortic valve forces the heart to work harder than normal, leading to fatigue, weakness and eventually heart failure. For most sufferers the condition is treatable with aortic valve replacement, a form of open heart surgery in which the diseased valve is replaced. However due to the risks associated with this type of invasive surgery not everyone is a suitable candidate for treatment. Around 30per cent of people with aortic valve stenosis are unsuitable candidates for open heart surgery and the only therapy available for them is through medication. However, even with medical management, these patients generally have a poor prognosis.

TAVI provides an alternative way of inserting a replacement aortic valve into a patient’s heart without the rigors of open heart surgery.  Doctors start by inserting the balloon catheter, which contains the replacement valve, through the artery at the top of the right leg, and advance it up to the patient’s heart.  The balloon is then expanded and the valve stretched into place where it takes over the functioning of the patient’s narrowed aortic valve. The procedure takes 1-2 hours hour, and the patient can leave the hospital after 3-4 days. This short operation and quick recovery time is in contrast to open-heart surgery, which can last four to six hours, and can take up to three months to recover from.

“TAVI is a new and truly groundbreaking procedure that not only helps improve a patient’s quality of life but also helps improves their long term prognosis,” commented Dr Kennon. “Aortic stenosis is a high prevalence disease in the elderly and with the UK’s aging population it is becoming more and more frequent. A clinical trial recently published in the New England Journal of Medicine has demonstrated a 20 per cent absolute reduction in mortality over one year in a high risk cohort and this was accompanied by a substantial improvement in quality of life.”

Dr Richard Maddison of the British Cardiac Patients Association (BCPA), who has been following the developments of TAVI at the London Independent Hospital commented: “The development of TAVI is impressive. Recent research findings are a valuable contribution to knowledge – showing how much better TAVI is over the previous standard therapy for the relevant patients. The BCPA welcomes what has been achieved.”

“The London Independent Hospital is proud to be pushing forward the boundaries of treatments available to patients with heart disease,” commented interim Executive Director Liz Sharp at the London Independent Hospital. “This new minimally invasive procedure offers hope to patients throughout the UK, who previously would not have been eligible for treatment.  Dr Kennon is at the forefront of what can be achieved through minimally invasive techniques and we are proud to bring such advanced treatments within the reach of private patients, on both a local and international level.”