Angiogenesis: Take 1
JFK Medical Center is one of five institutions in America participating in a Phase I trial to test Cardio Vascu-Grow.
Residents of Palm Beach County who suffer recurrent angina (chest pain) despite previous treatment have a new option. Made by Cardiovascular BioTherapeutics, Cardio Vascu-Grow is a protein that encourages angiogenesis, or the growth of blood vessels in the heart. A small incision is made in the chest wall, and the protein is injected into the area needing additional blood flow to reduce angina.
“Its exciting to research new ways to treat angina,” says Joshua Kieval, M.D., Co-Director of the Cardiovascular Laboratory and board-certified cardiologist on staff at JFK. “Our involvement in trials puts us on the cutting edge of medicine and brings alternative therapies close to home for our patients.”
Managing the Mitral Valve
Chest pain, heart murmur and shortness of breathall of these signs of danger to the heart may be the result of mitral regurgitation. If left untreated, this condition could lead to heart failure or stroke.
Understanding the Diagnosis
For the heart to function properly, the upper chamber (left atrium) must pump blood through the mitral valve and into the left ventricle (the largest chamber of the heart). However, when disease damages or weakens the mitral valve, blood backwashes into the left atrium and lungs, a condition called mitral regurgitation. “Mitral regurgitation is a serious condition with severe repercussions,” says Malcolm Dorman, M.D., Medical Director of Cardiac Surgery at JFK Medical Center. “Therefore, its important to treat mitral regurgitation earlybefore the heart suffers permanent damage.”
(l-r) Dr. Joshua Kieval, Co-Director of JFK Medical Center Cath Lab, and Dr. Malcolm Dorman, Medical Director of Cardiac Surgery
Rebuilding the Valve
Traditionally, patients with mitral regurgitation were treated with medications or mitral valve replacement. Thanks to new techniques and technologies, mitral valve reconstruction is giving patients new hope for treatment with minimal invasion. During the procedure, the damaged mitral valve is located through a three-inch incision. Small synthetic strings are then attached to reinforce the weakened area to prevent blood from flowing the wrong way. The patient is typically out of bed the evening of surgery and returns home in less than a week.
“With mitral valve reconstruction, we can take a diseased valve and make it normal again,” explains Dr. Dorman, who has a zero percent mortality rate when performing the procedure. “Patients have more energy and feel great after the procedure and most return quickly to their daily routines with no limitations.”
Heart Valve Surgery
While there are several options for treating mitral valve disease, Dr. Dormans approach to treating a leaking mitral valve is different than many clinicians. Rather than treat mitral valve disease with one therapeutic option, Dr. Dormans approach is a disease specific etiology based strategy. In other words, in order to provide the patient with a stable long term mitral valve repair, it is necessary to completely understand the cause of the valvular dysfunction.
For example, a degenerative mitral valve may need a repair strategy that restores the natural 3:4 ratio of the mitral valve. To accomplish this Dr. Dorman utilizes advanced surgical repair techniques. With other types of mitral valve disease, a remodeling ring designed to support the valve may be all that is needed. For very sick, Chronic Heart Failure (CHF) patients there is a new technique that not only repairs the leaking mitral valve, but also helps remodel the heart to improve the patients health. Depending on other disease states and the condition of the patient, it will be determined if a small minimally invasive approach is best for the patient.
