Artificial aortic heart valve trial reveals dramatic increase in survival rates

Washington: Results from a landmark clinical trial of an artificial aortic heart valve that does not require open heart surgery at the Loyola University Medical Center in Chicago showed positive outcome, with high survival rates and low rates of stroke.

"This is a major breakthrough. Not only did patients live longer, but their quality of life improved substantially," Fred Leya, MD, co-principal investigator at the Loyola site, said.

The other co-investigator at Loyola is Mamdouh Bakhos, MD.

The heart valve is called the Medtronic CoreValve System. It is deployed with a catheter, which is inserted into an artery in the groin and guided up to the heart. Once in place, the artificial valve takes over the function of a diseased valve.

"It saved me a great deal of pain and suffering from not having to have my chest cracked open," Loyola patient Martin Rogus, who participated in the clinical trial, said.

While recovering from the valve placement, he said, "It almost felt like they didn't do anything."

Rogus said that before receiving the new valve, he could not walk a single block without having to stop and catch his breath. Now he can walk a mile slowly, without stopping.

The valve is being studied in patients with severe aortic stenosis. This condition occurs when the heart's aortic valve is narrowed, restricting blood flow from the heart to the body. The valve doesn't open properly, forcing the heart to work harder to pump blood.

Symptoms include fatigue, dizziness, chest pain/pressure, heart murmur, shortness of breath during activity, heart palpitations and fainting.

Aortic stenosis can lead to heart failure and death. About 100,000 people in the United States have aortic stenosis. Currently in the United States, the standard treatment is to replace the aortic valve through open-heart surgery.

The initial phase of the trial included 471 patients at 40 centers who were extremely frail and had complex medical problems that made them too sick for open heart surgery.

One year after implantation, 76 percent of the patients were still alive, a remarkable result considering how ill they were. And only 4.1 percent had experienced major strokes within that first year, which was significantly lower than expected. 

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