05 Oct Advancements in Cardiac Procedures Highlight Ever-Evolving Treatment Options
Premature deaths from cardiovascular disease have reached their highest rate in England for more than a decade. Research from the British Heart Foundation (BHF) noted that since 2020, the rate at which people under 75 die from heart problems has risen significantly. While many cardiovascular conditions can be managed with lifestyle changes or medications, a significant number of individuals may experience a need for surgery or a minimally invasive procedure. Over time, innovative enhancements and devices have brought newfound routes to effective treatment, from transcatheter devices to advancements in robotics.
Innovative transcatheter procedures
Transcatheter procedures play a key role in regard to cardiovascular treatment options, and there are no shortage of different types. The transcatheter mitral valve repair and transcatheter aortic valve fusion are just two examples of such procedures. Transcatheter valve implantation is just one common type of transcatheter procedure. Also known as TAVI, the procedure aims to successfully replace a faulty aortic valve with a new valve that is created from natural animal tissue. The aortic valve plays a crucial role, as it controls the blood flow from the heart to the body — when the aortic valve stiffens, narrows, or otherwise is unable to work efficiently, it can result in more pressure put on the heart to pump harder. This can result in an increased risk of heart failure, a fact that underlines the value in a minimally invasive approach like TAVI.
It’s imperative to note that there are advancements that expose additional options for patients with specific cardiovascular conditions, which can effectively open the door to minimally invasive options. HospiMedica International details one device that can help patients with tricuspid regurgitation (TR). Tricuspid regurgitation occurs when the tricuspid valve of the heart doesn’t fully close. As a result, blood flows backward (regurgitates) rather than forward. “This backward flow makes the heart work harder and weakens it over time,” HospiMedica article explains, and further adds that patients with TR typically experience fatigue, leg swelling, and congestion in both the liver and kidneys. The article details the emergence of
a minimally invasive option for patients who are unable to undergo surgery — the TriClip transcatheter edge-to-edge repair system (TEER) from Abbott in Chicago is “specifically designed to treat TR,” according to HospiMedica. To exhibit the success of the system, the TRILUMINATE Pivotal trial has demonstrated that patients who are treated with TriClip experience “significant improvements in both symptom severity and quality of life, with benefits lasting at least one year.”
Advancements in robotic procedures
“Almost anyone can be a candidate for robotic heart surgery, except for very sick patients or those who’ve had prior surgery on their chest,” states Arnar Geirsson, MD and chief of cardiac surgery at Yale Medicine. While a traditional open surgical approach may be better depending on the case, robotic surgery presents an array of advantages — among these include a lower risk of complications than with open heart surgery,
and a quicker recovery. In regard to advancements in the field of robotic cardiac surgery, UChicago Medicine details the evolution of robotic cardiac surgery in a 2019 interview with Husam Balkhy, MD, which included the mention of novelties at the time like percutaneous aortic valve replacements
and improvements in ventricular assist devices.
One 2020 review details
the future of open heart surgery in relation to robotics and minimal surgical interventions. While it’s noted that a number of procedures are performed with robotics (such as mitral valve, atrial septal defect, and intracardiac tumours), concerns in regard to safety, cost, and clinical efficacy are still prevalent. Furthermore, it’s explained that limitations and management challenges can play a role as well, each of which are factors that can be addressed with the implementation of novel strategies and careful patient selection. In recent news, Portsmouth Hospitals University NHS Trust has launched the UK’s first
robot-assisted day case surgery programme. The programme works to implement a dedicated system, installed into a day surgery unit at PHU’s Queen Alexandra Hospital, highlights the National Health Executive article. As such, the initiative is expected to provide surgeons with the opportunity to treat a range of conditions with robotic-assisted surgery — the first phase has already aimed to convert all existing keyhole surgery in the unit to robotic-assisted surgery.
Advancements in cardiovascular medicine have resulted in expanded treatment options that range from innovative transcatheter procedures and devices to an evolution in robotic surgeries. Such advancements have not only become the norm, but have revolutionised how conditions like heart disease can be treated with options that put the patient’s comfort and outcome at the focus of treatment.
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Last Updated on October 7, 2024 by Marie Benz MD FAAD
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