Where new drugs fail, new surgical procedures and devices can help.
It’s brand new and involves fixing a non-closing valve with a closure device without open-heart surgery, which will make my heart work better, she wrote. Cardiac regulators immediately recognized the MitraClip from Abbott Laboratories, which had not yet been approved by the Food and Drug Administration. Taylor was apparently one of the people involved in the ongoing research phase. Two days after the surgery, she posted another entry on the website: As if I had a brand new heart.
If approved, the device will enable surgeons to repair non-closing valves without the need for a full open-heart surgery. They’ll be able to do this through two notches the size of a keyhole. A study presented at a recent meeting of the American Heart Association found that MitraClip does not prevent blood from leaking through the mitral valve that separates the upper left ventricle from the lower one as effectively as the traditional method of opening the chest and performing surgery. However, it has fewer complications. It can therefore be a solution for patients for whom open-heart surgery is too risky.
“We need more data, but I’m impressed with the initial results,” said Sidney Smith, director of the Center for Cardiovascular Medicine and Research at the University of North Carolina. As technology advances, this creates the possibility that patients who are not the right candidates for surgery will benefit from it.
The number of deaths from cardiovascular disease has fallen by 30% in the last ten years. thanks to drugs that lower blood pressure and cholesterol, as well as devices that help patients survive the dangerous period after a heart attack or cardiac arrest. Heart disease is the leading cause of death in America, with 630 deaths each year from it. people. Experimental treatments have struggled to remedy other common, costly, and dangerous problems such as heart attacks, valve problems, and other heart rhythm disturbances. The new gadgets that the medical equipment industry is working on can help a lot for some patients.
One of the biggest unresolved problems is heart failure, which means the muscles in the heart become too weak to pump blood. Nearly 6 million Americans are affected. Accumulating fluids fill the lungs, making patients feel as if they are drowning. Old medications such as beta blockers (beta blockers) and water tablets (diuretics) can prevent fluid build-up. So they increase the chances of survival. However, if the patient feels bad enough to be admitted to the hospital, he most often returns there many times. Almost all attempts to create new drugs have failed. Treating heart attack patients costs the U.S. health care $ 30 billion a year. So it is the most expensive disease for you.
In a study of 1820 patients, scientists proved last year that a new type of medical implant could reduce the number of patients hospitalized after a heart attack by 40 percent. Failed hearts aren’t weaker, they just pump in the wrong rhythm. Cardiac resynchronization therapy (CRT) is the insertion of a special type of pacemaker that uses electrodes to help the heart’s ventricles to pump in one rhythm. Arthur Moss of the University of Rochester, the electrophysiologist who conducted the tests, notes that the device was far more effective in women than in men – good news, especially since women have a much greater problem with heart failure.
Based on the research, a group of advisers from the Food and Drug Administration recently recommended that CRT be allowed in nearly 4 million patients.
CRT devices are manufactured by Medtronic, St. Jude Medical and Boston Scientific, which also funded the Moss study. The irony is that some time ago, all devices to regulate cardiac arrhythmias were temporarily withdrawn from the market due to bureaucratic confusion that could take weeks.
For people with severe heart failure waiting for a transplant, new devices have been created to help them wait for surgery. These devices support the work of the heart by helping to pump blood. Last year, this type of external device, the HeartMate by Thoratec, was also approved for those patients with heart disease for whom transplantation is impossible due to age or disease. Abiomed of Massachusetts, on the other hand, sells small heart support pumps that can be implanted with a catheter.
What actually causes such life-threatening heart problems is one of the greatest mysteries of cardiology. Every year, more than 200 thousand People experience sudden cardiac arrest, which is the stopping of the heart and causing death. In people from high-risk groups, i.e. people after a heart attack, the work of the heart can be restored by an implantable defibrillator (ICD device). However, much research needs to be done to establish the genetic rationale and other ways of identifying who may be affected.
2,5 million people experience atrial fibrillation, a disorder where the heart occasionally shakes instead of beating, making it dizzy. People suffering from this can be very active – they can even be athletes (atrial fibrillation has been seen in basketball legends Jerry West and Bill Bradley). However, the tremor can lead to blood clots which lead to strokes. This means that many patients need to use medications to thin the blood. Currently, the only solution is Coumadin, an old drug that needs to be dosed carefully. Boehringer Ingelheim, Johnson & Johnson, Pfizer, Merck and other pharmaceutical companies are working on new and better solutions.
Preventing strokes, however, does not make patients feel better on a daily basis, and medications that regulate the rhythm of the heart can have serious side effects that limit their use. Therefore, many hopes are placed on a new surgical procedure – catheter ablation. The procedure involves destroying those parts of the heart that are causing the arrhythmia. One of the tests conducted on a group of 245 people using the Medtronic device confirms that 70 percent. patients after ablation had a year without an attack of atrial fibrillation. In people taking medications, it was 7 percent.
Clyde Yancy of Baylor Medical University, the current president of the American Society of Cardiology, warns that it is unclear whether ablated patients can discontinue blood thinning medications. It is also unclear whether the reaction is sustained. However, he is hopeful. “We are still looking for a solution to the problem of atrial fibrillation and it looks like the technology cannot be taken lightly,” he explains.
81 million Americans, one third of adults, suffer from some form of cardiovascular disease that includes risk factors such as high blood pressure or high cholesterol.
Matthew Harper, Forbes 24.03.2010