Saturday, April 7, 2012

Closed-heart aortic valve replacement, good surgery and good science

Here is an article from a San Antonio, Texas paper about replacing the aortic valve in the heart without cracking the chest, but instead using a minimally-invasive catheter technique:

http://www.kens5.com/news/New-heart-valve-replacement-doesnt-involved-open-heart-surgery-146475805.html

This is absolutely thrilling news. Open-heart surgery is one of the most inherently worrisome and fraught forms of surgery, with an unbelievably painful post-op recovery phase. Simply cracking the chest is a big deal, and anything they do after that might be tricky but it's not nearly as shocking to the body.

Taking the chest-cracking out of heart surgery is the single biggest change we can make to safer, saner, faster-healing, less complicated heart surgeries. We WANT people to survive the experience intact, we really do!

Aortic valve issues are, as I recall from my ICU/Telemetry nursing, one of the more common heart issues; although it's not often life-threatening, it is often life-limiting, because without that "aortic kick" that the heart gets from a good, solid snapping-closed of the aortic valve during a heartbeat, the pumping action just isn't as good, and that has knock-on effects that can pile up over time.

Weak aortic valves can contribute to everything related to an impaired heartbeat, including blood pressure, vessel competence (think of congestive heart failure and tissue swelling/edema), and most obviously to cardiac hypertrophy, where an underpowered heart grows extra muscle to try to push blood around. What that really does is create more demand for blood from the heart itself, and push more blood back out the incompetent aorta!

Now that surgery can correct aortic valve issues without open-heart surgery, watch the medical news over the next 2-3 years: you're going to see a lot more studies directly relating aortic valve problems to other conditions, like those mentioned above. Why now? Because, once a problem can be solved, physicians are much more willing to look at the problem directly.

Just like the rest of us. :)

It's important to note that, for people with CRPS who have to avoid surgery as much as is compatible with life, and for those with dysautonomia for other reasons, this surgery is a game-changer. No longer do we have to choose between increasingly incompetent valves and a lifelong upsurge in agony, disruption, and dysregulation. Now, we can have a surgery that goes near two major nerve bundles but, if properly done, touches neither; solves the problem and gives us our hearts back; and lets us get on with making the best of our lives.Talk about a win/win!