Tuesday, July 17, 2018

Mass General physicians first in New England to perform minimally-invasive transcatheter mitral valve replacement

The team, from left to right: Michael Young, MD, Gaston Cudemus, MD, Ignacio Inglessis, MD, Jonathan Passeri, MD, and Sergei Melnitchouk, MD.

Mass General physicians first in New England to perform minimally-invasive transcatheter mitral valve replacement

Physicians at Massachusetts General Hospital’s (MGH) Corrigan Minehan Heart Center recently marked a significant milestone by becoming the first team in New England to perform a transcatheter mitral valve replacement in a non-calcified mitral valve—a minimally-invasive procedure for patients who suffer from mitral valve regurgitation. The disease, which can cause patients to feel symptoms like shortness of breath and fatigue, occurs when blood flows back through the diseased valve to the atrium of the heart. Statistics show one in five patients age 70 and older are affected by this condition. If left untreated, it can lead to heart failure. Traditionally, patients able to receive replacement valves do so through open-heart surgery.

“The importance of replacing this valve without the patient having to undergo a full, open procedure can’t be overstated,” says Jonathan Passeri, MD, co-director of the MGH Heart Valve Program. “Patients spend much less time in the operating room, don’t have to be put on a heart-lung machine, and we hope, will recover much faster.”

The procedure is performed by making a small incision between the ribs, inserting a catheter through the apex of the left ventricle, and implanting the transcatheter heart valve in the mitral position. The team, which is comprised of an interventional cardiologist, a cardiac surgeon, an echocardiographer, and anesthesia specialist, then inserts the replacement valve in place of the old one. The operation can be completed in less than an hour compared with traditional open-heart surgery which may take several hours.

The procedure was part of the APOLLO trial, a national study to analyze the effectiveness of the new synthetic valve administered via a catheter versus through traditional open heart surgery. Participants for the trial are adults experiencing moderate to severe mitral valve regurgitation who are candidates for a valve replacement.

“The pace at which this field is accelerating is exciting for us and hopeful for patients,” says Serguei Melnitchouk, MD, cardiac surgeon, co-director of the Heart Valve Program, and co-principal investigator of the trial. “We’ve seen the impact that minimally-invasive aortic valve replacements have had on patients for more than a decade, and the possibility of replicating that success with the mitral valve, which is significantly more difficult, is inspiring.”

While the procedure is a notable event in the treatment of heart valve disease, it’s not the first time the MGH Heart Valve Program has made history. Ten years and one day before this procedure, a team of MGH specialists were also the first in New England to perform a transcatheter aortic valve replacement.

“We are so fortunate to have such an amazing team of caregivers here at MGH,” says Ignacio Inglessis-Azuaje, MD, interventional cardiologist, and co-principal investigator for APOLLO. “From the physicians to the nurses—both in the operating room and on the floors—you can’t ask for a more talented and collaborative team and the benefit to the patient is immeasurable.”

 

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