Repairing hearts without major surgery

January 5, 2011 10:00:00 PM PST
Doctors say a minimally invasive procedure is changing lives for some children with heart disease.

Leaky heart valves can impact daily life by causing chest pain, weakness, dizziness, shortness of breath and more. It can also lead to serious medical problems.

Until recently, a fix wasn't easy, especially for those with congenital heart defects. But now there's a breakthrough treatment, and it came just in time for a Chicago teen.

Like most 15-year-olds, Nicholas Tobar enjoys video games and texting his friends. But this Chicago teenager is far from ordinary.

Tobar was just a couple days old when doctors discovered a congenital heart defect. He had open heart surgery right away. At three months, he needed another surgery to fix his heart valves.

Tobar is deaf. Doctors believe that due to the complexity of his case his hearing was damaged early on. The surgeries continued, and so did his fight to defy the odds.

"The surgeon told us at the time that he was hoping to get 5 to 10 years out of the pulmonary valve and aortic valve they put in, but that he could not have any more open-heart surgeries because they could only open the heart so many times."

Recently, the valves started to leak again, meaning they were not opening and closing properly. That weakened blood flow to the lungs.

Doctors were running out of options. And then came a newly approved minimally invasive procedure. One of Tobar's valves could be replaced without major surgery.

"It was a miracle. Just when he needed it, it was approved here," said Dawn Tobar.

Instead of cracking open the chest, doctors at Children's Memorial Hospital in Chicago inserted a catheter into a vein and guided an artificial valve up to Tobar's heart.

It's called the melody valve and when it is placed over the leaky pulmonary valve it pops open with the help of a stent and starts working.

"The stress to the patient their circulatory system the scar in their chest is much, much less. It's a much less invasive procedure surgically," said Dr. David Wax, pediatric cardiologist, Children's Memorial Hospital.

Replacing worn out heart valves without major surgery has been described as one of the most exciting events in cardiology in the last 50 years. But for now only the melody device for the pulmonary valve is approved in the United States. Research is ongoing on other valves.

Rush University Medical Center is currently studying a replacement device for the aortic valve which can leak as people get older.

Many elderly Americans are turned down for the traditional surgery because it is considered too risky. The less invasive approach, which is still investigational in the U.S., seems to offer a fix with less risk and pain.

"These patients clearly get better. They feel better. They return to normal lifestyles in a way that would not be possible if we didn't have this treatment," said Dr. Clifford Kavinsky, cardiologist, Rush University Medical Center.

As research continues on the aortic valves and the newer technique, Nicholas Tobar hopes his success with the pulmonary valve encourages others to consider the option.

"He would walk up the stairs and it was hard to breath. He was always huffing and puffing. Now it is better, he has more energy," said Dawn Tobar.

The melody valve is not a permanent fix, but doctors say it should last for many years.

As for the aortic valve, the less invasive procedure is being done in Europe and clinical trials in the U.S. continue.

Melody Valve

Rush University Medical Center
(888) 352-7874 or 888-352-RUSH.

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