Clinical Trial Studies New Treatment For High-Risk Heart Patients

A clinical trial under way at the East Carolina Heart Institute is testing the benefit of a new medical device designed to help high-risk people suffering from leaky heart valves.

Dr. W. Randolph Chitwood Jr., director of the Heart Institute and professor of cardiovascular surgery at the Brody School of Medicine at East Carolina University, secured the clinical trial for the MitraClip System for the treatment of mitral valve regurgitation (MR). A serious heart condition, MR can lead to arrhythmias and congestive heart failure if left untreated.

Dr. Curtis Anderson, a cardiothoracic surgeon and assistant professor of cardiovascular sciences, and Dr. Ramesh Daggubati, a cardiologist and clinical professor at Brody, collaborated to perform mitral valve repairs on two patients at Pitt County Memorial Hospital without making the traditional incision in the center of the chest to access the heart. Chitwood joined Drs. Rajasekhar Nekkanti and John Cahill, ECU cardiologists, to assist in the procedure.

In each case, the multidisciplinary team of cardiologists and surgeons placed a thin catheter in the patient’s groin vessel, guided a tiny clip through the heart’s septum and placed the clip between the leaflets of the valve to stop the leak.

“With mitral insufficiency, we normally use the heart/lung machine to either repair or replace the valve,” Chitwood said. “This new procedure is catheter-based, and can be used in high-risk patients who wouldn’t do well on the heart/lung machine. These patients have severe symptoms stemming from the leaky valve and can’t be operated on safely any other way.”

Chitwood said this new procedure “gives the East Carolina Heart Institute an entirely new set of tools for mitral valve repairs in high-risk patients. It is the least invasive way that we can fix a valve. Centers selected to perform these procedures have demonstrated expertise in applying new medical technology under FDA (Food and Drug Administration) guidelines.”

With the clip, patients leave the hospital the next day and within two or three days return to normal activities – or, in many cases, better-than-normal activities.

“Most of the patients are very sick,” said Daggubati, a clinical associate professor of cardiovascular sciences. “Medical management is the only option for them because surgeons consider the risk too high and the patients inoperable.”

Anderson said patient selection is the key to a successful outcome.

“I think a lot of patients with heart failure will be attractive candidates for this device,” he said, adding that collaboration among physicians is vital. “We want patients to have the confidence of knowing that cardiologists and cardiac surgeons are working side by side to give them the best possible outcomes.”

The mitral valve is a one-way valve that connects the left atrium to the left ventricle of the heart. With mitral valve regurgitation, the valve does not seal completely, and blood leaks back into the left atrium. This reversed flow can cause heart and lung damage, as well as death. Symptoms may include an audible heart murmur, shortness of breath and heart palpitations.

About the East Carolina Heart Institute
The East Carolina Heart Institute is a unique partnership that includes University Health Systems Pitt County Memorial Hospital and East Carolina University, along with cardiovascular experts in private practice, academic medicine and research. The East Carolina Heart Institute is the first in North Carolina devoted exclusively to education, research, treatment and prevention of cardiovascular diseases.

Via EPR Network
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Failure to Investigate Cosmetic Surgeon Can Cost You Your Life

A recent death illustrates the importance of investigating your cosmetic surgeon, says Dr. Mark Scheinberg from the Center for Cosmetic Laser Gynecology. Lidvian Zelaya, 35, underwent a procedure for abdominal liposuction and buttocks injections at the Strax Rejuvenation Clinic in south Florida.

She was rushed to the hospital, but died only a few hours after the start of the procedure. Investigations of public records by ABC News reveal that Dr. Roger L. Gordon, Zelaya’s plastic surgeon at Strax, has had 20 lawsuits filed against him since 2004. He was placed on probation by the Maryland Board of Physicians for undisclosed reasons and he had his staff privileges terminated by the Florida Medical Center. The Sun Sentinal revealed that Gordon was disciplined by the state in connection with two deaths in 2004.

“If you’re choosing a plastic surgeon, you want to do your homework,” says Scheinberg. “You’re entrusting them with your body – and your life. You need a doctor you can have confidence in.”

Scheinberg has been board certified in obstetrics and gynecology since 1981 and has performed over 10,000 surgical procedures. Scheinberg has received 100s of hours of training with Professor Adam Ostrzenski, M.D. Ph.D., a pioneer in safe, effectivevaginal reconstruction and cosmetic vaginal surgery.

Zalaya’s cause of death is under investigation, but she was declared healthy enough for surgery by doctors at the Strax Clinic. “I think it’s an inherent conflict of interest if you are getting screened by the surgeon who wants to do the procedure,” said Spencer Aronfeld, a malpractice attorney retained by Zalaya’s husband, Osvaldo Vargas.

Vargas has been publicizing the case as a way of warning others to investigate their cosmetic surgeons. In particular, he is urging patients to get a second pre-operative examination by an independent doctor. He said that Zelaya chose the Strax Clinic because she got a good deal on the procedure.

“You don’t want to rush into this kind of decision or select the doctor who offers you the lowest cost,” notes Scheinberg. “You want someone who has a long record of success with the procedure you are getting. Complaints and disciplinary actions against doctors are part of the public record. Patients can and should look this information up.”

Via EPR Network
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