There are three things that you need to know about tissue-based implantable heart valves. One, they are often preferable to mechanical valves because they don’t require life long blood-thinning. Two, implantation involves suturing the ring into the place where the old valve stood. Three, the leaflets wear out in about 10 years, meaning you eventually need another major surgery to replace the whole valve – until now.
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Cleveland Clinic cardiac surgeon Lars Svensson, MD, PhD, helped develop a new valve replacement technology that eliminates the need for open heart surgical implantation and replacement of prosthetic tissue valves. It’s called ValveXchange. This technology has three parts: a permanent implantable ring; easily replaceable leaflets; and the tools that can quickly implant the ring and remove and replace the leaflets.
The operation is performed through a small incision in the chest. If a second operation is later needed, with further research it may possibly be done via a small incision on the left chest wall trans-apically (through the pointy part at the bottom of the heart). This would allow for replacement leaflets to be inserted by taking out the old and inserting new leaflets.
If patients are not candidates for minimally invasive “keyhole” replacements which has excellent results (99.4% survival 2011, 99.6% survival first six months of 2012), some of these patients may be eligible for transcatheter valve replacement (TAVR) – another minimally invasive approach.
Dr. Svensson performed the first-in-man implantation of ValveExchange in 2011. Trials are commencing in Europe and the manufacturer will be seeking European regulatory approval.
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