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October 17, 2003



Procedure Could Replace Open Heart Surgery For Mitral Valve Repair

ATLANTA ­ Richard Kraus has known for a couple of years that one of his heart valves needed repaired. When he began to feel winded from walking up the small hill in front of his home in Stone Mountain, his doctor told him his heart’s mitral valve was leaking and he would continue to feel weakened until the problem was fixed.

Until recently, his only course of treatment was open heart surgery, a major procedure that could take several months of recovery time. That is until he met Emory Cardiologist Peter Block, MD.

Block performed the world’s fifth non-surgical repair of the mitral valve on Kraus, 75, in early September at Emory University Hospital. The innovative procedure uses a catheter to attach a tiny metallic clip to a leaking mitral valve, the heart valve that separates the left upper chamber of the heart from the left lower chamber.

The procedure may eliminate the need for open-heart surgery in some patients, like Kraus, who suffer from significant mitral valve regurgitation.

Mitral valve regurgitation is a progressive, long-term disorder in which the mitral valve does not close properly and blood leaks backward with each heartbeat, causing the heart to work harder. It affects approximately 4 million people in the United States. About 250,000 develop significant mitral regurgitation annually.

Patients with significant mitral regurgitation eventually become so weakened by the condition that they require open-heart surgery to replace or repair the damaged mitral valve. About 44,000 U.S. patients undergo open-heart surgery annually for mitral-valve repair.

The new procedure is minimally invasive. Under full anesthesia, a catheter (a thin, flexible plastic tube), introduced through the skin in the thigh area, is guided through the femoral vein into the affected area of the heart. A smaller delivery catheter that holds the implantable clip is slipped through this tube, so the clip can be guided into place and attached to the leaflets (the "swinging doors") of the mitral valve. Once the clip is securely attached, the delivery catheter is removed. The entire process is monitored by an echocardiogram. The initial patients returned to normal activity within a few days.

The procedure is under an FDA-approved Investigational Device Exemption, and has been performed on five patients world-wide. The procedure will be under the FDA Exemption through the 10th patient, and then will enter clinical trials.

"The results are showing promise that open heart surgery will not be the only option for patients suffering from mitral valve regurgitation," says Block. "There are many benefits - it is much less invasive since it is done through a catheter, and recovery time is quicker."

To be eligible for the investigational procedure, candidates must have moderate to severe mitral regurgitation and be experiencing symptoms (fatigue, chest pain, shortness of breath); or, lacking these symptoms, they must have a weakened left ventricle.

Before his procedure, Kraus would have to stop halfway up the driveway to his house to catch his breath. Today he can jog the small hill with no problems. "This was a good alternative for me," he said at a follow-up visit with Dr. Block on Oct. 8. "I am very happy I didn’t have to undergo open heart surgery, and the recovery time has been short. I would recommend this to anyone."

About Emory Hospitals and the Emory Heart Center
Emory Hospitals include Emory University Hospital, a 587-bed hospital located on the Emory University campus in northeast Atlanta, Emory Crawford Long Hospital, a 583-bed, community-based hospital in midtown and Wesley Woods Hospital, a 100-bed geriatric hospital located on the Emory campus. Emory Hospitals are components of EMORY HEALTHCARE, the most comprehensive health care system in Atlanta. Other components of EMORY HEALTHCARE are: The Emory Clinic, the Emory Children's Center, the jointly owned Emory-Adventist Hospital, and EHCA, LLC, a limited liability company created in collaboration with HCA Healthcare.

The Emory Heart Center is comprised of all cardiology services and research at Emory University Hospital (EUH), Emory Crawford Long Hospital (ECLH) Carlyle Fraser Heart Center, the Andreas Gruentzig Cardiovascular Center of Emory University and the Emory Clinic. Ranked in the top ten of U.S. News & World Report's annual survey of the nation's best Heart Centers, the Emory Heart Center has a rich history of excellence in all areas of cardiology - including education, research and patient care. It is also internationally recognized as one of the birthplaces of modern interventional cardiology.

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