U of Wisconsin surgeon might have found replacement for mitral valve surgery

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A University of Wisconsin (UW) Health System cardiovascular surgeon could be closing in on a solution for patients who are too sick to have mitral valve surgery.

Lucian Lozonschi, MD, is testing the new approach—transcatheter mitral-valve replacement—and said it has the potential to make mitral valve replacement surgery an option for sicker patients.

“We can target initially the patients with sickened hearts and multiple medical problems, offering them hope,” Lozonschi said. “These are individuals who would otherwise be left to die of their heart valve disease, people who couldn’t survive the standard operation.”

Mitral valve replacement can be performed through small incisions, sometimes with the help of a surgical robot, even without stopping the heart, but it cannot be performed without heart-lung bypass, the UW researchers said.

Lozonschi delivered the replacement valve through a catheter that is placed through a small chest incision and guided through the tip of the heart—while the heart is beating—to the site of the damaged valve. Once there, the replacement valve expands into place, opening up what had been blocked or damaged, which is the same kind of technique cardiologists have been using to place umbrella stents in patients with clogged arteries.

?Lozonschi developed the technique along with Georg Lutter, MD, a cardiovascular surgeon and professor in Kiel, Germany. In the last months, Lozonschi has performed the transcatheter procedure on several pigs at the UW in Madison, all of which survived the surgery.

“The main success here is replacing the whole valve without the heart and lung machine,” Lozonschi said. “In the long term, this could be a milestone development in the field of endovascular valve therapy.”

Not only is the process potentially less expensive, but patient trauma and recovery time is significantly shorter as well, UW researchers said.

If clinical trials in animals and humans prove successful, Lozonschi expects that the procedure could be available as standard treatment in the next seven to eight years.