Novel Technique Provides Alternative to Open Heart Surgery
WINSTON-SALEM, N.C. – Jan. 5, 2015 – 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.
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
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.”