Heart repair without surgery

AORTIC STENOSIS: The aortic valve controls blood flow from the left ventricle to the aorta. It is the largest artery in the human body. A healthy aortic valve does not restrict the flow of blood from the heart into the aorta at all; however, if a person develops aortic stenosis, their aortic valve becomes narrow and impedes the flow of blood. When the valve becomes stenotic, the left ventricle must pump harder to keep blood flowing into the aorta, which in turn increases the pressure in the left ventricle. Over time, that can lead to an increase in muscle mass or a thickened left ventricle. Aortic stenosis is most common among elderly patients over 70 years of age, but can surface earlier in life in those with rheumatic heart disease or congenital abnormalities of the valve.

TRADITIONAL VALVE REPLACEMENT: Traditional valve repairs and replacements require open heart surgery, which involves breaking the breastbone, stopping the heart and hooking patients up to a heart-lung machine. After surgery, patients spend one to three days in the intensive care unit (ICU), a week at the hospital and at least four to six weeks recovering at home, before resuming normal activities.

This surgical procedure has been used to treat aortic stenosis for more than 30 years; however, doctors are concerned that in patients with advanced age, end-stage disease or other serious health concerns, an open chest procedure has the greater risk for problems or possibly death.

SKIPPING THE OPEN HEART: It's estimated that anywhere from one-third to two-thirds of patients who are in need of aortic valve replacement don't get it because of excessive risk factors for open heart surgery complication. Percutaneous aortic valve replacement provides a new tool for doctors to treat patients who currently cannot be treated with traditional surgical techniques. The Cribier-Edwards Percutaneous valve is a bioprosthesis made of three leaflets of equine pericardium sutured to a balloon expandable stainless steel stent. The new valve is inserted through a small puncture incision near the groin, through a catheter and fed up through an artery to the heart. Once the new valve is in place, the balloon is inflated, opening the stent and pushing the old valve out of the way to make room for the new valve. Once the new valve is secured, it immediately starts working. During the procedure, pictures of the heart and aortic valve are obtained through three-dimensional echocardiography (ultrasound) or X-ray and the images are transmitted to aid the cardiologists as they perform the procedure.


The Andreas Gruentzig Cardiovascular Center of Emory University
(404) 712-7667

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