New aortic valve system at Central DuPage offers less invasive alternative to traditional open heart surgery

Northwestern Medicine Central DuPage Hospital (CDH) is the first hospital in Chicago's western suburbs to offer a recently approved less invasive, "sutureless" or "rapid deployment" aortic valve for patients with aortic valve disease.

The new rapid deployment system combines the precision of open surgery with elements of transcatheter aortic valve replacement (TAVR). It also facilitates minimally invasive valve replacement surgery.

"With the new system we are able to deploy the heart valve in about 10-15 minutes compared to 45 minutes using conventional techniques," said Neil J. Thomas, MD, attending cardiovascular surgeon at Northwestern Medicine Central DuPage. "Patients experience less trauma and significantly reduced time on bypass. This should translate into quicker recovery and decreased need for blood transfusions."

Just days after his surgery, 75-year-old Joseph Posledni of West Chicago, remarked that he couldn't believe how small his incision was. Posledni, a grandfather of four, is eager to once again see his grandkids' wrestling matches and extracurricular activities.

"For the last several years I was really feeling winded and tired, and that really held me back from doing what I wanted," said Posledni. "I thought it was just old age, but now I'm looking forward to being more active."

The new system requires only three sutures compared to 12-15 in traditional valve surgery followed by balloon deployment. Unlike a TAVR procedure, surgeons remove the flaps of the diseased valve to position a new valve. A balloon catheter is placed inside the valve, holding it open to expand a metal frame that holds the valve in place.

"Like any stent, the frame exerts outward force resulting in a round valve opening that provides better flow characteristics than a conventional valve replacement," said Dr. Thomas. "With better flow characteristics we can infer patients will have better long term outcomes and improved quality of life."

Patrick McCarthy, MD, executive director of Northwestern Medicine Bluhm Cardiovascular Institute and chief of cardiac surgery at Northwestern Memorial Hospital, trained and assisted the team that implanted the first valves at CDH. Dr. McCarthy led the clinical trial at Northwestern Medicine Feinberg School of Medicine for the new valve prior to its approval by the FDA in August 2016.

"We are always looking to find the safest and most effective means of treating our patients, and I am pleased we can now offer this new technology at Northwestern Medicine Central DuPage Hospital," said Dr. McCarthy, who is also the Heller-Sacks Professor of Medicine at Northwestern University Feinberg School of Medicine.

According to the American Heart Association, aortic stenosis is one of the most common and most serious valve disease problems. Aortic stenosis mainly affects older people, due to scarring and calcium buildup in the valve cusp. With a growing elderly population, aortic stenosis is anticipated to become a major public health concern.

"We now have a spectrum of treatment options," Dr. Thomas said, "from catheter-based to rapid-deployment and minimally invasive to conventional surgery to meet the needs of all of our patients with this disease."

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