UW Health Surgeons Test Groundbreaking New Mitral Valve Treatment

UW Health Services
Mitral Valve Replacement, Sans Heart-Lung Machine
MADISON - More than 40,000 patients undergo mitral heart valve repair or replacement surgeries in the United States each year. The surgery can be performed through small incisions thoracoscopically, and it can be done using a surgical robot, but it can't be done without a heart-lung bypass machine to stop the patient's heart while the surgeon repairs it.
That's a serious problem for sick and elderly patients, whose damaged hearts often aren't strong enough to survive heart bypass.

Lucian Lozonschi, MD, a UW Health cardiovascular surgeon, is pioneering a new surgical method that may eliminate the need for the heart-lung machine altogether. It's called transcatheter mitral valve replacement, and it has the potential to make mitral valve replacement surgery an option for sicker patients.

"We can target the appropriate patients and offer them hope," says Dr. Lozonschi. "These are individuals who would normally be sent to nursing homes to die of their heart valve disease, people who couldn't survive an operation."

Instead of opening the patient's chest completely or using multiple incisions to insert instruments thoracoscopically, Dr. Lozonschi delivers the replacement valve through a catheter that's guided through a small chest incision at the apex of the heart to the site of the damaged valve. Once there, the folded replacement valve is allowed to exit the catheter, opening what had been blocked or damaged. The technique is similar to one cardiologists use to place umbrella stents in patients with clogged arteries.

Dr. Lozonschi perfected this technique overseas along with Georg Lutter, MD, a cardiovascular surgeon and professor at the University of Kiel in Germany. Dr. Lozonschi has performed the transcatheter procedure on several pigs, all of which survived the surgery.

"The main success here is replacing an atrioventricular valve without the heart-lung bypass machine. The mitral valve has a complex anatomy and an undesirable location for implantation of a valved stent," says Dr. Lozonschi. "In the long term, this could be an important breakthrough in the field of endovascular valve therapy."

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

If surgical trials in animals and then in humans prove successful, Dr. Lozonschi expects that the procedure could be available as standard treatment in the next seven to eight years.
Date published: 4/28/2008