Recent decades have witnessed a clear trend toward less invasive medical procedures, especially in cardiac surgery. Cardiac catheterization uses wires inserted through tiny incisions and observed through advanced imaging technology to perform heart surgery. This method currently provides a major alternative to conventional surgery for the treatment of obstructed mitral valves in the heart. At Israel's premier medical complex, the Rabin Medical Center, efforts are being made to develop a similar minimally invasive option to treat obstructed atrial valves, a condition known as aortic stenosis.
Healthy patients will likely still receive a traditional surgical valve replacement, but percutaneous aortic valve implantation, as this new method is called, may provide older or otherwise infirm patients relief from its symptoms, which include angina and fainting spells, or even longer lives. Preliminary studies have already shown that percutaneous aortic valve implantation is both feasible and effective in elderly patients with aortic stenosis in the short and medium term.
In Israel, there are about one-thousand aortic valve replacement surgeries per year. That number excludes the 10%-20% of those who could benefit from a valve replacement but are unable to undergo the surgery. The remaining 100-250 patients could be candidates for the new, minimally invasive alternative. However, by mid-2009 only about 40 percutaneous aortic valve implantation procedures had ever been performed in Israel.
At Israel's Rabin Medical Center, Dr. Ran Kornowski, Director of Interventional Cardiology, is collaborating with the Department of Cardiothoracic Surgery to promote percutaneous aortic valve implantation. Details of the procedures carried out so far were reported during the 57th Israel Heart Society Congress that took place from April 14 to 15, 2010 in Tel Aviv in association with the Israel Society of Cardiothoracic Surgery. As awareness of this procedure grows and patient selection, technology and technique improve, it will hopefully allow doctors throughout Israel and the world better attend to the needs of more patients suffering with this condition.
The Rabin Medical Center Department of Cardiothoracic Surgery is one of the oldest such departments in the country, initially established in 1951.
Ran Kornowski, MD, FACC, FESC, is Director of the Cardiology Department and the Institute of Interventional Cardiology at Rabin Medical Center. He is full Professor of Cardiovascular Medicine at the Sackler Faculty of Medicine at Tel Aviv University.