Israeli doctors have been performing catheter-based valve replacement surgery on high-risk cardiac patients for several years, and due to the procedure’s high success rate, are saying they may expand the use of the procedure to mid-risk patients as well, despite the considerable expense of the procedure.
Surveys at 10 hospitals across Israel which have been using the innovative procedure have reported a 95 percent success rate, with 90% of patients displaying general clinical improvements. Since August 2008, 1,053 valve replacements have been performed in Israel. In 2010, the procedure gained momentum when the Health Ministry agreed to subsidize the procedure for up to 200 patients, at a cost of NIS 150,000 per patient.
Aortic valve replacement surgery is performed when a patient has a blockage that prevents the aorta, the largest artery in the body, from delivering oxygenated blood to the rest of the body. People with aortic blockages suffer from shortness of breath from any effort, heart failure and fainting spells. Such a condition has a high mortality rate and requires surgical intervention. The procedure is usually open-heart surgery, but the catheter-based version allows doctors to unblock the aorta without requiring massive surgery. The procedure has been approved in Europe and is undergoing clinical trials in the U.S.
"The surgical treatment is very effective. For high-risk and elderly patients and patients with other diseases in tandem, the risks of surgery are very high and we don't recommend it. For these patients, we offer catheter-based valve replacement," explained Professor Haim Danenberg, head of the Cardiovascular Research Center at Hadassah Hebrew University Medical Center. Danenberg is also in charge of collecting the data from the10 Israeli hospitals that have been using the procedure. His data shows that most of the patients recommended for this procedure were elderly patients, with an average age of 82, a figure similar to other countries such as France, Germany and England.
"Valve replacement is a secure and effective method for the high-risk patient group," Danenberg said. "There is some pressure to allow the procedure for mid-risk and low-risk patients as well, but we are talking about an expensive procedure. We have a sense that over the next few years, however, we will expand the scope of this procedure and at least include mid-risk patients."