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St. Louis woman receives heart valve without open-heart surgery

  • January 18, 2008
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By Julie Bierach, 90.7 KWMU-FM, January 18, 2008

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A St. Louis woman is the first patient in the region to receive an experimental heart device to replace her defective aortic valve without having to undergo open heart surgery. That''s according to doctors at Barnes- Jewish hospital, who say that the experimental technique has the potential to be one of the most significant advances in all of cardiac medicine.

For years, 78 year-old Mary Ann Cahalin, a retired registered nurse and mother of five, has had heart problems. She has a defective aortic valve because of severe aortic stenosis, a narrowing of the aortic valve, which inhibits blood flow from her heart to the rest of her body.

"I was worn out. I could hardly walk around my own house. I couldn''t even make a whole bed without sitting down. I couldn''t stand at the sink and do a whole sink full of dishes, I had to sit in between," said Cahalin from her hospital room. "August of 06 I had an echogram, where they took pictures of the heart and they found it. And they told me I would only have two years to live if something wasn''t done."

To fix such a condition, patients usually have to undergo open heart surgery. For Mary Ann that wasn''t an option because of her age and previous complications from by-pass surgery. But today, Maryann sits in a chair in her room on the 7th floor of Barnes- Jewish hospital, feeling better. On Tuesday of this week, she underwent an experimental procedure that replaced her defective valve without opening her chest wall or using a heart-lung machine. She''s part of a nationwide clinical trial that''s evaluating the effectiveness of a new device.

Dr. John Lasala is principal investigator of the trial and professor of medicine at Washington University''s School of Medicine. He says the new technique uses a catheter to thread a replacement valve into the heart.

"It goes in through a tube in the leg and it goes up into the central artery on the way to the heart. We then can steer across the valve first using a wire and then using a balloon to sort of prop open the valve a little bit to allow us entry eventually with the valve itself," said Dr. Lasala who is also medical director of the cardiac catheterization laboratory at Barnes-Jewish Hospital.

Dr. Lasala says the technique is very similar to a stent procedure, which is commonly used to open the arteries around the heart.

"And that stent once deployed pushes the old valve to the side and inside that stent is the patient''s new valve, made out of a tissue that comes from the lining around a cows heart."

In her room, Mary Ann is surrounded by family. It''s been only a few days since she underwent the procedure and already she says she can feel the difference. She says she could tell the first night after surgery that she was breathing better.

Dr. Lasala says if the device is as effective in other patients; it could benefit some 200,000 people per year who suffer from the same condition as Mary Ann.

"Well if the technique is approved it means that a large segment of our population that has this entity of aortic stanosis or the narrowing of the main valve, as many as a third of them might be poor surgical candidates if not completely inoperable," said Dr. Lasala. "So we''d like to think that a whole different segment of our critically ill population might be delivered a new technology that they might not ordinarily have access to."

Mary Ann is the first in the region to undergo the procedure; only about a hundred of them have been done so far in the United States and Canada. Mary Ann says she''s happy to be the first one.

"I''m rather proud, because I believe in a lot of education. And somebody has to be the first one," said Mary Ann with a smile. "At first, I didn''t want to be, but it didn''t work out that way, I had to be. And it worked out fine."

Mary Ann Cahalin is doing so well, she''s expected to be release from Barnes- Jewish Hospital today.

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