A 68-year-old Gresham man is doing well after becoming the first Oregonian to have his mitral valve replaced without open-heart surgery at OHSU.
OHSU is the third institution nationwide to perform this procedure as part of the APOLLO Trial, which is evaluating the safety and efficacy of Medtronic’s IntrepidTM Transcatheter Mitral Valve Replacement, or TMVR, system.
“Until now, the only way to replace artificial mitral valves has been invasive open-heart surgery, which can be grueling and even dangerous for patients with severe co-morbid [two chronic] conditions” said one of the physicians who led the procedure, Firas Zahr, M.D., an assistant professor of medicine (cardiovascular medicine) in the OHSU School of Medicine and co-director the OHSU Knight Cardiovascular Institute’s Complex Heart Valve Program.
Zahr co-led the replacement procedure with Howard Song, M.D., Ph.D., a professor of surgery (cardiothoracic) in the OHSU School of Medicine and the other co-director of the OHSU Complex Heart Valve Program.
"The OHSU Complex Heart Valve team is delighted to be able to offer trial participants a cutting-edge option for mitral regurgitation that offers potential for a safer, quicker recovery,” Song said. “The world's first successful mitral valve replacement was performed at OHSU in 1960 and this procedure follows in our tradition of developing new treatments for heart valve disease."
The participant, Dennis Troxel, had the procedure after he was thought to be too sick to undergo open-heart surgery. He has had at least five heart attacks and severe, long-term mitral regurgitation. He decided to apply to participate in the trial after a doctor told him he might have just one to five years left to live.
“I’d like other heart patients to know that there are options,” Troxel said. “There’s more than just living with what’s put before them.”
Troxel underwent the minimally invasive surgery after his own mitral valve – one of four valves in the heart – deteriorated and caused a condition called mitral valve regurgitation, which affects about 4.1 million people in the U.S. The condition involves blood flowing backwards through the mitral valve, leading to symptoms such as fatigue, shortness of breath, and leg swelling, and can lead to heart failure or death if not treated.
The artificial mitral valve is made of cow heart tissue and includes two wire mesh stents, all of which are compressed into a thin capsule. The compact device was placed in a catheter, which is inserted through a small incision near one of the participant’s ribs. Study doctors used live-motion X-rays and ultrasound waves to track the device’s movement during insertion. Once the device reached the participant’s existing mitral valve, the stents were opened up to support the new tissue valve.
This procedure is similar to another method used to replace a different heart valve, the aortic valve. OHSU also implants artificial aortic valves with that procedure, called the transcatheter aortic valve replacement, or TAVR. However, Zahr describes the mitral valve as being more delicate and therefore more challenging to replace.
The OHSU team for the procedure also included Scott Chadderdon, M.D., Stephen Heitner, M.D., Valerie Sera, M.D., and James Mudd, M.D.
Patients interested in participating in the APOLLO Trial at OHSU should call 503-494-1775.