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New minimally-invasive procedure replaces damaged heart valves

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Aortic stenosis is a condition in which the aortic valve becomes constricted and severely impacts one’s health, leading to death. The valve can be replaced with open heart surgery; however, it is a major surgical procedure requiring a heart-lung mchine. Many sufferers of aortic stenosis are too ill to tolerate the procedure. Last January, the food and Drug Administration approved the CoreValve device, manufactured by Medtronic, Inc., for use in patients too ill for open heart surgery. To obtain the latest information on the device, I consulted with cardiac surgeon Michael J. Reardon, M.D.

Dr. Reardon informed me that in 80% of cases, the device can be inserted in the femoral artery in the upper thigh and passed upward to the damaged valve; once in place, it is deployed and pushes the damaged valve aside. The procedure can be performed with sedation and a local anesthetic. To date, 50,000 procedures have been performed worldwide and about 5,700 have been done in the United States. At Dr. Reardon’s hospital, Houston Methodist Hospital, 235 have been performed. He noted that patients suffering from significant aortic stenosis die that a rate of 2-4% per month; in addition, many have a severely-impacted quality of life. They require repeated hospital admissions and often wind up spending their final days in a nursing home. The improvement in quality of life after the procedure is dramatic. Dr. Reardon cited an example; he performed his first procedure on a 91-year-old man. His patient is now 94, works every day, and plays golf twice a week.

Dr. Reardon explained that the first CoreValve device was inserted in 2004, and the device has a good overall durability record for five years. In addition, the device functions as well as the devices inserted via open heart surgery. In addition, a new, improved smaller device in under development because some patients' arteries are too small to admit the present version. He notes that a wealth of information is available at the CoreValve website. He also stresses that a patient should first consult with his family physician and/or cardiologist to determine whether he or she is a candidate for the procedure.

Dr. Reardon grew up in Houston, Texas, where he attended Baylor College of Medicine. He completed a five year general surgery residency under Dr. Michael DeBakey in the Baylor Affiliated Hospitals and a two year cardiothoracic residency under Dr. Denton Cooley at the Texas Heart Institute. He has started and run his own private practice as well as served on the full time faculty of Baylor College of Medicine where he was Professor of Surgery and Chief of Cardiothoracic Surgery, and Program Director for the Thoracic Surgery Residency and Vice Chair of Academic Affairs in the Department of Surgery. He has spent his entire career at The Methodist Hospital serving in numerous administrative positions including President of the Medical Staff.