by DrCiuffo | Jul 31, 2015 | Aortic Valve Stenosis, Blog, Minimally Invasive Aortic Valve Surgery
Many aortic valve stenosis patients come to me with the false assumption that transcatheter heart valve treatments are preferable to minimally invasive surgical aortic valve replacements. We want to set the record straight that the very best option for most patients is the minimally invasive heart valve replacement. THV treatments come with a large set of risks and is much more dangerous than surgical aortic valve replacements. THV is not approved by the FDA for treatment of aortic valve stenosis unless patients are a very high and prohibitive risk for a surgical AVR. Surgical aortic valve replacement is a much better and safer therapy than transcatheter heart valve surgery in the overwhelming majority of aortic valve disease cases. THV carries a risk of stroke that is up to four times higher than surgical AVR. For this reason, I do not know of any heart surgeon in good faith and in his right mind who would choose a THV rather than a surgical AVR for himself. There is no guarantee that the valve used in transcatheter heart valve surgery will last as long as the bioprosthetic valves currently used in surgical methods. There are not sufficient follow up data to support how long the valve will last with THV. We currently have decades of follow up data on most surgical prosthetic valves. THV has a much higher incidence of perivalvular leak (a leak between the THV valve and the implant site). In surgical aortic valve replacement, perivalvular leaks are extremely rare. If the groin arteries are small or heavily calcified, the risk of serious injuries when the THV catheter is deployed through them... by DrCiuffo | Jul 7, 2015 | Aortic Valve Stenosis, Blog
Aortic Valve Stenosis Aortic Valve Stenosis is a serious condition that causes the aortic valve to become too tight and barely open. The heart is forced to work very hard to push fresh blood through the narrow opening. At onset of this disease, the heart can adapt by thickening the cardiac muscle to increase strength. Unfortunately, the heart will eventually tire out and it creates life-threatening conditioning. If a patient is diagnosed with moderate-to-severe aortic valve stenosis, no matter how elderly or frail, the patient must undergo replacement surgery to avoid death in a matter of months. Aortic valve stenosis is a deadly disease that requires immediate attention. Aortic Valve Insufficiency An Insufficiency means that the aortic valve leaks when it is closed. The blood that is supposed to flow out the heart, end up flowing backwards. In order to guarantee an adequate flow of blood, the heart must again work very hard. With the help of medical therapy, most patients with aortic valve insufficiency can live without symptoms for a period of time. When the heart begins to wear out, patients will experience symptoms of congestive heart failure. Patients that have been diagnosed with Aortic Valve Insufficiency must have regular, careful follow up appointments with a cardiologist. This will ensure that surgical therapy can be offered before it is too late. Minimally Invasive Aortic Valve Replacement or Repair Without surgery, the majority of patients will die within three years of symptom onset. Dr. Ciuffo performs a minimally invasive aortic valve replacement that is significantly less traumatic to patients. Most patients are able to return to their lives two or three days after... by DrCiuffo | Feb 6, 2015 | Aortic Valve Replacement, Aortic Valve Stenosis, Blog
If a patient is diagnosed with moderate-to-severe aortic valve stenosis, no matter how elderly or frail, the patient must undergo replacement surgery to avoid death in a matter of months. Aortic valve stenosis is a deadly disease that requires immediate attention. Severe symptomatic aortic valve stenosis is a lethal condition that needs effective mechanical relief in the form of aortic valve replacement. There is no other medical treatment for this disease. Some doctors avoid this surgery for elderly and frail patients, but this is the worst possible course of action. Without aortic valve surgery, three-quarters of these patients will die within three years of symptom onset (shown in graph 1). The following graph shows the life expectancy of patients who undergo replacement surgery (blue line) versus the survival rate of patients who do not have surgery (red line). As you can clearly see, surgery is the right course of action. The life expectancy of patients with aortic valve stenosis who undergo an aortic valve replacement is the same as any patient of the same age that has never be affected by aortic valve disease. Minimally Invasive Aortic Valve Replacement For Frail Patients A well-meaning relative will ask: “Isn’t Grandma too old and frail to withstand open heart surgery?” Dr. Ciuffo’s answer will always be: “No. Grandma is too old and frail to withstand severe aortic valve stenosis. Let me show the statistics on this condition!!!” The way Dr. Ciuffo performs a minimally invasive aortic valve replacement has dramatically changed the impact of this operation on the overall patient’s experience and on the speed of recovery. Most patients, even the elderly and frail, will be able to return to their...
