When a patient with aortic valve issues starts blacking out, it's time to replace the valve. Not everyone can have the typical procedure, because some patients can't tolerate the open-chest operation. But there's an alternative procedure which bypasses invasive surgery.
The first time Joe Rostich passed out, he was grateful he was visiting a neighbor, "I says, 'Marilyn,' I says, 'something's happening. I'm going to faint.' next thing I knew I was in the hospital."
Joe's fainting spell was caused by a narrowed aortic valve, called aortic stenosis. It limited bloodflow to his brain. "In the setting of having aortic stenosis, it's, it's a bad harbinger. It means that it's gotten to a point where the body is not compensating well," says Dr. Mauricio Garrido.
Valve replacement is the usual fix. But for some, the open-chest procedure is too dangerous. "Many of our patients are at much added risk given advanced age, other medical problems and the fact that they may have had heart surgery before," according to Dr. Paul Addonizio.
Scar tissue from a previous surgery meant Joe's chest couldn't be re-opened. So his doctors offered an alternative: aortic valve bypass. "We do this with a incision that is from the side and not through the front, so it avoids any type of injury to the connections," says Dr. Garrido.
He says the surgery leaves the ailing valve in place, but places a new valve and bypass tube on the apex of the heart, "Once it's in place, the bloodflow can leave the conduit, go through a valve that allows it to only go in one direction to the rest of the body."
The surgery's also done off-pump, meaning the heart keeps beating and pumping the whole time. "I believe that it definitely has benefits in terms of protecting the patient as best as possible and keeping his heart perfused with good oxygen-rich blood during the procedure," says Dr. Garrido.
Aortic valve bypass is offered at a limited number of sites in the U-S. Dr. Garrido says as the population continues to age, there will be a greater need for the procedure.
