Expandable Heart Valves Could Mean Fewer Surgeries

March 18, 2019 -- Expandable heart valves that can be placed in the heart through a minimally invasive procedure appear to be as safe or safer than those implanted through surgery, according to two news studies.

That means many more patients might be able to avoid risk heart surgeries and get the expandable valves instead, experts say.

Expandable aortic valves are guided to the heart through a catheter into a blood vessel and placed inside the old valve. They were developed about a decade ago but are used only in patients at high or moderate risk of dying from surgery to implant a new valve, the Associated Press reported.

These two studies assessed the use of expandable heart valves in people who were at low risk from surgery, which is most patients.

One study included about 1,000 patients who underwent standard surgery or received an expandable Edwards Lifesciences valve. After one year, 15 percent of the surgery group and 8.5 percent of the expandable valve group had died, suffered a stroke or needed to be hospitalized again, the AP reported.

The second study included 1,400 patients who had standard surgery or received a Medtronic expandable valve. Estimates based on partial results suggest that after two years, 6.7 percent of the surgery group and 5.3 percent of the expandable valve group had died or suffered a disabling stroke.

In that study, 17 percent of expandable valve recipients later required a pacemaker, compared with 6 percent of people who had surgery, the AP reported.

However, in both studies, problems such as major bleeding and the development of atrial fibrillation were more common among those who had surgery.

The studies were published in the New England Journal of Medicine on Saturday and were to be discussed at an American College of Cardiology conference in New Orleans on Sunday, the AP reported.

Price was an issue: Expandable valves cost about $30,000, compared with $5,000 for surgical valves.

However, prior research suggests that overall costs for expandable valves are lower because they cause fewer complications and require much shorter hospital stays, according to ACC spokesman Dr. Joseph Cleveland, a University of Colorado heart surgeon who was not involved in the studies and does not have any links to the companies that sponsored them.

Cleveland and other experts also said long-term studies are needed to determine if expandable valves are as durable as surgical valves, the AP reported.

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