Now, thousands may avoid open-heart surgery
A Minimally Invasive Procedure Reserved For The Old & Sick Is Good For Younger, Healthier Patients Too: Study
Gina Kolata 18.03.2019
The operation is a daring one: To replace a failing heart valve, cardiologists insert a replacement through a patient’s groin and thread it all the way to the heart, maneuvering it into the site of the old valve.
The procedure, called transcatheter aortic valve replacement (TAVR), has been reserved mostly for patients so old and sick they might not survive open-heart surgery. Now, two large clinical trials show that TAVR is just as useful in younger, healthier patients.
It might even be better, offering lower risks of disabling strokes and death, compared to open-heart surgery. Cardiologists say it will likely change the standard of care for most patients with failing aortic valves.
“Is it important? Heck, yes,” said Dr Robert Lederman, who directs the interventional cardiology research programme at the National Heart, Lung and Blood Institute. The findings “were remarkable,” he added.
Lederman was not involved with the studies and does not consult for the two device companies that sponsored them.
In open-heart surgery, a patient’s ribs are cracked apart and the heart is stopped to insert the new aortic valve.
With TAVR, the only incision is a small hole in the groin where the catheter is inserted. Most patients are sedated, but awake through the procedure, and recovery takes just days, not months, as is often the case following the usual surgery.
The studies are to be published in the New England Journal of Medicine and presented Sunday at the American College of Cardiology’s annual meeting.
The Food and Drug Administration is expected to approve the procedure for lowerrisk patients. As many as 20,000 patients a year would be eligible for TAVR, in addition to the nearly 60,000 intermediate- and high-risk patients who get the operation now.
The study led by Mack and Dr Martin Leon, an interventional cardiologist at Columbia University in New York, tracked deaths, disabling strokes and hospitalizations at one year following the procedures. The rates were 15% with surgery versus 8.5%with TAVR.
Aortic valve replacements have been performed for decades, and surgeons know the valves placed during surgery last at least 10 to 15 years. It remains to be seen if TAVR valves will fare as well. At the moment, it will be up to most patients which procedure they choose, Popma said — TAVR or surgery. NYT NEWS SERVICE
In open-heart surgery, a patient’s ribs are cracked apart and the heart is stopped to insert the new aortic valve. With TAVR, the only incision is a small hole in the groin where the catheter is inserted. Recovery takes just days, not months
Eating extra half-egg a day ups risk of cardiovascular disease by 6%: Study
The debate over whether eggs are good for you is age-old: while a good source of protein, they also contain potentially harmful cholesterol. Now, a new study — published by the Journal of the American Medical Association (JAMA) — has weighed in. After analyzing 30,000 Americans from six separate studies, researchers concluded that eating an extra half-egg a day increased the risk of cardiovascular disease (6%) and premature death (8%) over the study period. That is relatively little, especially given that a half-egg daily is double what the average American eats. Separately, the study found an additional 300 milligrams of dietary cholesterol per day increases the risk of heart disease by 17% and premature death by 18%. But 300 mg is twice the average daily amount eaten by Americans. A large egg contains about 186 mg of cholesterol. The new data suggest that eating eggs increases the risk of heart attack or stroke, although the study does not establish a causal link. AFP
A Minimally Invasive Procedure Reserved For The Old & Sick Is Good For Younger, Healthier Patients Too: Study
Gina Kolata 18.03.2019
The operation is a daring one: To replace a failing heart valve, cardiologists insert a replacement through a patient’s groin and thread it all the way to the heart, maneuvering it into the site of the old valve.
The procedure, called transcatheter aortic valve replacement (TAVR), has been reserved mostly for patients so old and sick they might not survive open-heart surgery. Now, two large clinical trials show that TAVR is just as useful in younger, healthier patients.
It might even be better, offering lower risks of disabling strokes and death, compared to open-heart surgery. Cardiologists say it will likely change the standard of care for most patients with failing aortic valves.
“Is it important? Heck, yes,” said Dr Robert Lederman, who directs the interventional cardiology research programme at the National Heart, Lung and Blood Institute. The findings “were remarkable,” he added.
Lederman was not involved with the studies and does not consult for the two device companies that sponsored them.
In open-heart surgery, a patient’s ribs are cracked apart and the heart is stopped to insert the new aortic valve.
With TAVR, the only incision is a small hole in the groin where the catheter is inserted. Most patients are sedated, but awake through the procedure, and recovery takes just days, not months, as is often the case following the usual surgery.
The studies are to be published in the New England Journal of Medicine and presented Sunday at the American College of Cardiology’s annual meeting.
The Food and Drug Administration is expected to approve the procedure for lowerrisk patients. As many as 20,000 patients a year would be eligible for TAVR, in addition to the nearly 60,000 intermediate- and high-risk patients who get the operation now.
The study led by Mack and Dr Martin Leon, an interventional cardiologist at Columbia University in New York, tracked deaths, disabling strokes and hospitalizations at one year following the procedures. The rates were 15% with surgery versus 8.5%with TAVR.
Aortic valve replacements have been performed for decades, and surgeons know the valves placed during surgery last at least 10 to 15 years. It remains to be seen if TAVR valves will fare as well. At the moment, it will be up to most patients which procedure they choose, Popma said — TAVR or surgery. NYT NEWS SERVICE
In open-heart surgery, a patient’s ribs are cracked apart and the heart is stopped to insert the new aortic valve. With TAVR, the only incision is a small hole in the groin where the catheter is inserted. Recovery takes just days, not months
Eating extra half-egg a day ups risk of cardiovascular disease by 6%: Study
The debate over whether eggs are good for you is age-old: while a good source of protein, they also contain potentially harmful cholesterol. Now, a new study — published by the Journal of the American Medical Association (JAMA) — has weighed in. After analyzing 30,000 Americans from six separate studies, researchers concluded that eating an extra half-egg a day increased the risk of cardiovascular disease (6%) and premature death (8%) over the study period. That is relatively little, especially given that a half-egg daily is double what the average American eats. Separately, the study found an additional 300 milligrams of dietary cholesterol per day increases the risk of heart disease by 17% and premature death by 18%. But 300 mg is twice the average daily amount eaten by Americans. A large egg contains about 186 mg of cholesterol. The new data suggest that eating eggs increases the risk of heart attack or stroke, although the study does not establish a causal link. AFP
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