Heart Valve Implantation Without Surgery
April 09, 2010
Robert J. Cubeddu, M.D.
Appointed Medical Director of Structural and Adult Congenital Heart Intervention at Aventura Hospital and Medical Center
Traditionally, heart valves have been repaired or replaced using open heart surgery. But for those patients considered too high risk for convention surgery, a new and innovative procedure may provide a healthy alternative. Dr. Robert J. Cubeddu is a board certified interventional cardiologist and one of the very few to hold a subspecialty in “Structural and Adult Congenital Heart Interventions,” a new cardiovascular field that uses catheter-based technology to provide patients a less invasive and attractive alternative to open-heart surgery.
Dr. Cubeddu has brought his expertise to Aventura Hospital and Medical Center, where he has been appointed the Medical Director of this new Structural and Adult Congenital Heart Intervention Program. Essentially, he is able to repair or replace certain heart valves with catheters, also known as “percutaneous or transcather valve implants or repair.”
“The percutaneous valve is innovative and of complex technology,” comments Dr. Cubeddu. They are naturally of porcine origin, however once purified, they are attached to a metallic frame, similar to that of a stent, which can be compressed over the surface of a balloon catheter. By crimping the valve smaller, it may then be introduced through the femoral artery or femoral vein, and advanced to the heart, after creating only a small incision at the level of the groin. Once in place, the balloon is inflated at high pressure to expand and deliver the new artificial valve, which has now substituted the damaged valve. The balloon and catheter is then removed. In other words, the artificial valve, once delivered inside the native one, assumes its function and replaces it without having to remove it.
Dr. Cubeddu explains that the fundamental basis of Structural and Adult Congenital Heart Intervention arises from the successful experience gained over the last 30 years with heart catheterizations, balloon angioplasty and stents that are used to open the obstructed coronary arteries. He explains that the very first human percutaneous valve implant was performed in Europe in the year 2000, and since then, it is estimated that more than 8,000 patients world-wide have benefited from this new technology. This technology is particularly useful and important for patients with valvular heart disease that are either inoperable or simply high-risk for conventional surgery.
Additionally, many other heart conditions may now be treated with this novel transcatheter technology, including congenital heart defects and cardiac stroke related problems. A few of these examples include: closure of patent foramen ovale, patent ductus arteriosum, atrial septal defect, ventricular septal defect, arterio-venous malformations, and left atrial appendage among others.
Dr. Robert Cubeddu is a member of Florida Heart and Vascular Care at Aventura and completed his Interventional Cardiology, Structural Heart Disease and Adult Congenital training at the Massachusetts General Hospital of Harvard Medical School in Boston, MA. He was former Chief Resident in Medicine at the Mount Sinai Medical Center of Miami Beach, FL, and is currently Board Certified in Internal Medicine, Cardiovascular Medicine, Adult Echocardiography, and Nuclear Medicine. Dr. Cubeddu has published in many major peer-review journals for his work in the subspecialty field of structural heart intervention and is currently a representative of the National Structural Heart Disease Council. He is also a member of the American College of Physicians, American College of Cardiology, and the Society for Cardiovascular Angiography and Intervention.
“We should not forget that open-heart surgery in patients with aortic stenosis is currently still the elective procedure of choice, that results in improved clinical symptoms and long-term survival,” he cautions. “Unfortunately, in a high percentage of patients with aortic stenosis, open-heart surgery may be prohibitive and of high risk. It is in these patients that the alternative percutaneous valve replacement intervention becomes attractive.”