Special Report – The Company That Won My Heart
Special Report – The Company That Won My Heart
If you're ever told you need a new heart valve, and that the only way to do it is by sawing apart and prying open your ribs, your surgeon is likely to give you a choice...
Would you like a biologic or mechanical valve?
That's the one decision, in all likelihood, you'll have to make.
It's something people anguish over...
The younger, the more the anguish since biologic valves are increasingly being used in younger and younger people.
The trouble is, there’s a good chance a biologic valve will need to be replaced. The leaflets in these valves are made from the tissue of cows (bovine) or pigs (porcine), and generally last somewhere between eight and 15 years... sometimes going as long as 20.
By contrast, mechanical valves are made of titanium or carbon, and can last a lifetime. But they require regular blood monitoring and the use of blood thinners.... and unlike biologic valves, which are silent, can have a clicking sound.
When I had my valve replaced nearly four years ago, I went the biologic route – cow, to be specific. I was 67 at the time and given my age, and while the choice was mine, biologic was the recommended option. "That would have been my choice, as well," said my surgeon at the Cleveland Clinic, who was slightly younger than I was.
The rest was up to him – including the manufacturer, size, and model.
Every year, an estimated roughly 182,000 people have heart valves replaced in the U.S. alone.
Of those, most involve the aortic valve, followed by mitral and the harder-to-reach tricuspid and pulmonary valves.
Most valves are still replaced the old-fashioned way: by stopping the heart, putting the patient on a heart-lung machine and then surgically removing the old valve before replacing it with a new one.
Through the Groin – A Game Changer
Thanks to newer technologies, more and more doctors are skipping the surgery and – with the heart still beating – dropping a new valve into the old valve through a catheter snaked up from the groin. This kind of transcatheter aortic valve replacement, or TAVR as it is better known, might be cannibalizing traditional valve replacements... but they're helping grow the entire market.
TAVR, which has been around for about a decade, was originally developed as a way to replace valves in older – as in over 80 years old – and other high-risk people who might not otherwise survive surgery.
It has since been extended to younger patients, with a goal to move it even lower... in part as a way to make heart valve replacement less scary.
It's the kind of surgery that singer Mick Jagger recently had, as well as actor Arnold Schwarzenegger, where TAVR was used to replace an existing artificial valve.
The same goes for a few of my friends, who marvel that they were out of the hospital in a day. Among them is veteran business journalist Allan Sloan, who even wrote about his TAVR in the Washington Post, saying...
I had my valve replaced on a Wednesday morning at Cooperman Barnabas Medical Center in Livingston N.J., which has an established TAVR program, and went home shortly after lunch Thursday.
It took only a few days to get back to my normal, feisty self. I was just amazed, and still am.
By contrast, while I was up and around a day or two after my five-hour surgery – and sitting at my desk working 11 days after surgery – I was in the hospital for eight days (a day or two longer than expected because of a minor complication) and my full recovery took two months.
There also are now transcatheter mitral valve replacements, with trials underway for the tricuspid and pulmonary valves.
The use of minimally invasive approaches to valve replacement is a game-changer, and very well could rapidly expand the market.
Not Something to Ignore
To understand why, here's a quick anatomy lesson...
The heart has four heart valves, and they all are supposed to have three leaflets. The aortic valve, such as the one I had replaced, is the most common of all valve replacements. As it opens and closes, it thrusts the blood up through your aorta to the rest of your body.
It becomes a problem if it gets too stiff or starts leaking, which means that with each beat instead of closing fully some blood will flow back into your heart. That's not something you feel... Instead, it's something your doctor will hear as a click-like sound in a routine exam, while listening to your chest through a stethoscope.
Murmurs are common, and doctors often tell patients they're "nothing to worry about," but to simply monitor.
That's fine as long as you get an annual physical. But many people don't and just ignore it – especially if they don't have symptoms, such as extreme fatigue, shortness of breath, or even chest pain.
Ideally, it’s best to get the valve replaced before symptoms arise... because once they start, there's a greater risk of irreversible heart damage – the kind that can lead to heart failure.
After all, if the valve can't pump properly, the blood can't get through your body. Your quality of life plummets... and your life in all likelihood will be cut short.
That’s how I came to know about one company…