Health Team

Duke trial might help kids avoid many heart surgeries

Posted June 22, 2009
Updated June 23, 2009

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— A trial at Duke Hospital is helping people born with a heart valve defect avoid several open-heart surgeries.

Kevin Osteen, 57, said he's heard the same thing from doctors since he was a child: "Do you know that you have a heart murmur?"

Echo cardiogram tests and stress tests, though, didn't show a problem. Then, two years ago, a heart catheterization revealed his problem.

"They found the bicuspid valve in the aortic position, and it was causing a narrowing of the aorta," Osteen said.

The valve had two leaflets instead of three. So in 2007 Osteen had open heart surgery where surgeons took his good pulmonary valve to replace his defective aortic valve. Then cadaver tissue was used to revise the pulmonary valve.

The cadaver valve typically lasts more than 10 years, but in just 2 years Osteen's valve started to twist and obstruct blood flow. That disrupted blood flow so that Osteen wasn't getting enough oxygen to his body. So that valve needed to be replaced.

Osteen enrolled in the feasibility phase of a trial. Duke Hospital is the second institution in the country to use the Edwards Sapien transcatheter heart valve for patients with Osteen's condition. The trial is only open in 3 sites in the country.

That device consists of three pieces of bovine pericardial tissue sewn into a metal stent frame.

"We can put it in through a catheter, and the patient can go home the next morning, whereas the surgery, being a major operation, is at least a three- to seven-day hospital stay," said Dr. John Rhodes, a pediatric cardiologist at Duke.

Most of Duke's pediatric cardiology patients in the trial will be teenagers, but what's learned from Osteen might help many children avoid multiple surgeries.

"Many of them will have 2 or 3 or 4 operations before they're 20," Rhodes said.

Osteen was so optimistic about the procedure, he planned to head on a Disney World vacation two days after leaving Duke Hospital.

"It's sort of like putting the procedure to the acid test," he said.

Dr. Rhodes hopes the device can one day be made small enough to use in the thousands of children born every year with heart defects. He will perform the procedure on 30 patients in the first phase of research.


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