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In a procedure done on July 30 in Terrebonne General Medical Center’s cardiac catheterization laboratory, interventional cardiologist Dr. Peter Fail and cardiovascular surgeon Dr. Edgar Feinberg became the first physicians in the state to perform a heart valve implantation using the newly FDA approved CoreValve Evolut R System, the first adjustable device available in the United States.
The device provides a minimally invasive option for patients with severe aortic stenosis, or narrowing of the aortic heart valve. When aortic valves do not open properly, blood flow throughout the body is hindered and those with the most severe cases often require valve replacement.
The unique feature of this new device, Fail said, is the ability physicians have to retrieve and reposition the device to ensure it is fully functioning. The nickel titanium metal alloy frame provides the ability to adjust the device if it is too deep or too wide without having to completely remove it.
“One of the problems we have with the current generations of valves is that we have a lot of issues with getting them placed exactly where they need to be,” Fail explained. “What the Evolut does is allows us to recapture and retrieve it. If we don’t like the position, we can actually put it back into the delivery system, which then allows us to reposition it a little better. It’s really very, very precise positioning.”
This precise positioning minimizes the risk of future, consequential issues.
“We know historically when we look at precise position, the downstream effects tend to be minimized,” Fail said. “The big ones we are always worried about are pacemaker issues and paravalvular leak, which means it leaks on the outside of the valve. If we have that problem, we can actually reposition, try a different position, see if a different position will help us… A lot of these things are little, tiny nuances that make the procedure much better than five years ago. Then, we had no other option, and we were saying, ‘Wow, that’s great. The patient did really well but we had this little, subtle problem that we had to deal with.’ Well now, this valve now sort of takes care of a lot of that so we don’t have to do these extra little steps and we get a much better result overall.”
Guidelines to qualify for these valves are very specific, he added, and those that would have received an older generation valve are the same patients that would now be eligible to receive this transaortic valve replacement.
Dr. Peter Fail and Dr. Edgar Feinberg became the first physicians in Louisiana on July 30 to perform a heart valve implantation with the newly FDA-approved CoreValve Evolut R System, the first adjustable device that is available in the United States.
