Duke explores alternative to open heart surgery for murmurs

Posted June 23, 2009

Duke explores alternative to open heart surgery for murmurs

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Durham, N.C. —

A trial at Duke Hospital is helping people born with a defect in the aortic heart valve correct the problem without several open-heart surgeries.

Kevin Osteen, 57, said he's heard the same thing from doctors since he was a child: "Do you know that you have a heart murmur?"

Echo cardiogram tests and stress tests, though, didn't show a problem. Then, two years ago, a heart catheterization revealed his problem.

"They found the bicuspid valve in the aortic position, and it was causing a narrowing of the aorta," Osteen said.

The valve had two leaflets instead of three. That kept Osteen's blood from moving efficiently out of his heart, preventing his body from getting enough oxygen.

Osteen enrolled in the feasibility phase of a trial. Duke Hospital hosted one of only two centers currently enrolling patients in the United States. He is receiving the Edwards Sapien transcatheter heart valve.

That device consists of three pieces of bovine pericardial tissue sewn into a metal stent frame.

"We can put it in through a catheter, and the patient can go home the next morning, whereas the surgery, being a major operation, is at least a three- to seven-day hospital stay," said Dr. John Rhodes, a pediatric cardiologist at Duke.

Most of Duke's pediatric cardiology patients in the trial will be teenagers, but what's learned from Osteen might help many children avoid multiple surgeries.

"Many of them will have 2 or 3 or 4 operations before they're 20," Rhodes said.

Osteen was so optimistic about the procedure, he planned to head on a Disney World vacation two days after leaving Duke Hospital.

"It's sort of like putting the procedure to the acid test," he said.