Surgery to replace a damaged heart valve is now routine and relatively safe, but it is still major surgery. The surgeon accesses the damaged heart valve by splitting the sternum and pulling the two halves of the chest wall to expose the heart. Then after stopping the heart, he/she must open up the heart itself to replace the damaged valve. Open-chest, open-heart surgery generally can’t be done safely in patients older than about 80 years of age, especially if they also have other serious medical conditions.
Now there’s hope for such patients. The FDA has just approved a heart valve that can actually be implanted without major surgery. It’s called the Sapien heart valve. In its closed position, the Sapien valve fits on a catheter that can be threaded up the aorta to the heart from the femoral artery. When the valve is properly positioned, the surgeon inflates a balloon that opens the metal scaffold structure of the valve, locking it in place!
The Sapien valve is not for everyone. It’s about $20,000 more expensive than the standard valve replacement with open-heart surgery, and it’s riskier. The normal patient who needs a heart valve replaced should still undergo the normal open-heart procedure. Still, there is now an option for a class of patients who previously were out of options.