Health Team

Duke replaces heart valves without open-heart surgery

A common cause of heart failure in elderly people is a defective heart valve, but open-heart surgery to correct the problem may be too risky for some patients.

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DURHAM, N.C. — A common cause of heart failure in elderly people is a defective heart valve, but open-heart surgery to correct the problem may be too risky for some patients.

A new clinical trial at Duke University Hospital is testing a way to replace the valve without the risks of surgery.

Erika Paskman, 90, enjoyed golf for many years, until one game was suddenly interrupted.

“I said, 'Boy, I can't walk up there, my heart beats funny,’” she recalled.

It was the start of heart issues that were first managed by medications and a pacemaker. Her doctors then discovered a narrowing of the aorta at the heart and a faulty heart valve.

Duke cardiologist Dr. Kevin Harrison says open-heart surgery to replace the valve is the gold standard of treatment, but for those with medical problems or advanced age, it may not be worth the risk.

Duke researchers are part of a trial for a stent valve, which has been used in Europe for several years but not approved in the U.S. It's delivered in a compressed form via a catheter through a groin artery to the heart.

“The old valve is simply pushed out of the way, and it leaves this valve in its place,” Harrison said.

Paskman had the procedure done the day after Easter.

“They figured out at my age, when we can do it the easy way, let's do it the easy way, and this certainly was the easy way,” she said.

Rather than spend seven days in the hospital, Paskman was out in three days and walking her dog that Friday.

The trial at Duke is looking at the catheter-based stent valve in patients who are not at high risk, but of moderate risk of complications from open-heart surgery.

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