WINSTON-SALEM, N.C. Physicians at Wake Forest Baptist Medical Center have successfully performed a rare cardiac procedure with a technique that creates a new pathway to the heart for valve replacement.
Wake Forest Baptist is the first hospital in North Carolina and just the 11th worldwide to employ this method, called transcaval valve replacement. It provides a non-surgical option for patients with aortic stenosis – the narrowing of the aortic valve opening that prevents normal blood flow – when diseased blood vessels or other medical issues prevent traditional access to the heart.
The procedure was performed Dec. 17 by a team directed by David X. Zhao, M.D., chief of cardiovascular medicine and director of the Heart and Vascular Center at Wake Forest Baptist. The patient, a man in his seventies, responded well and was discharged from the Medical Center two days after the operation.
“This technique allows us to replace the aortic valve in patients who are not candidates for open heart surgery or conventional trans-catheter aortic valve replacement with fewer risks and complications,” Zhao said. “This procedure is possible at Wake Forest Baptist because of the collaboration between our cardiothoracic surgery and interventional cardiology teams, two once-separate units that now make up our multidisciplinary Heart and Vascular Center.”
During transcaval valve replacement, a wire is guided up the femoral vein through the leg and into the abdomen. Doctors then cross through the vein and reach into the aorta, the largest artery in the body. A catheter is placed between the two openings and doctors are then able to deliver the new heart valve across the bridge into the aorta. After the valve is placed, the catheter bridge is removed and plugs close the holes in the artery and the vein so the two blood vessels can function as normal.
In the Dec. 17 operation, Zhao was assisted by Robert J. Applegate, M.D., professor of cardiology; Sanjay K. Gandhi, M.D., associate professor of cardiology; Peter M. Belford, M.D., assistant professor of cardiology; Edward H. Kincaid, M.D., associate professor of cardiothoracic surgery; and Neal D. Kon, professor of cardiothoracic surgery.
“Being first in the state to employ this sophisticated valve-replacement technique is indicative of the superb heart and vascular care that’s provided here at Wake Forest Baptist,” said Karen Barbara “Bobbi” Carbone, M.D., M.B.A., president and chief operating officer. “It also illustrates our commitment to offering our patients the latest and most advanced treatments available.”