In a world first, a team of researchers at the National Institutes of Health (NIH) and Emory School of Medicine, Atlanta, has successfully performed a normal open-heart surgery without cutting the chest wall.
The team employed this novel intervention to prevent the blockage of a vital coronary artery, which is an infrequent but often lethal complication following a heart valve replacement.
The results in the journal Circulation: Cardiovascular Interventions suggested that, in the future, the method could offer a safer alternative to open-heart surgery for those at risk of coronary artery obstruction.
The procedure, called ventriculo-coronary transcatheter outward navigation and re-entry, or VECTOR, creates a new route for blood flow that is a safe distance away from the aortic valve.
And rather than cracking open the chest to do it, the doctors reach the heart by guiding catheters through blood vessels in the legs. While entering the heart this way is not new, what the researchers do once inside is unique.
Christopher Bruce, an interventional cardiologist at WellSpan York Hospital, and Vasilis Babliaros, M.D., at Emory, in collaboration with Adam Greenbaum, M.D., a physician at Emory School of Medicine, had put VECTOR into practice in a 67-year-old man.
His aortic valve, which controls blood flow from the heart to the body, had previously been replaced with a bioprosthetic valve. Over time, the calcium buildup necessitated the valve’s replacement again.
“Our patient’s extensive history of prior interventions, vascular disease, and other confounders eliminated the possibility of open-heart surgery.” Having a minimally invasive alternative in a case like this is paramount,” said Adam Greenbaum.
Six months after the procedure, the patient showed no signs of coronary artery obstruction, proving VECTOR to be a success in humans. Further deployments in more patients are still necessary before VECTOR is used more widely, but the team is hopeful of continued success following this major step forward.
The researchers suggested the new technique may also find some footing in treating coronary diseases more broadly, in cases where other approaches, such as stents, fail to keep arteries open
