Advances transforming cardiac care (USA)

Have a heart problem? If it's fixable, there's a good chance it can be done without surgery, using tiny tools and devices that are pushed through tubes into blood vessels. Heart care is in the midst of a transformation. Many problems that once required sawing through the breastbone and opening up the chest for open heart surgery now can be treated with a nip, twist or patch through a tube. These minimal procedures used to be done just to unclog arteries and correct less common heart rhythm problems. Now some patients are getting such repairs for valves, irregular heartbeats, holes in the heart and other defects - without major surgery. Doctors even are testing ways to treat high blood pressure with some of these new approaches. All rely on catheters - hollow tubes that let doctors burn away and reshape heart tissue or correct defects through small holes into blood vessels. "This is the replacement for the surgeon's knife. Instead of opening the chest, we're able to put catheters in through the leg, sometimes through the arm," said Dr. Spencer King of St. Joseph's Heart and Vascular Institute in Atlanta

Nurse-led service slashes cancelled heart ops (UK)

"A nurse-led service for patients having cardiac surgery has helped slash the number of cancelled operations and length of hospital stay at a south London trust. The service - a joint project between St George's Hospital Trust and the South West London Cardiac and Stroke Network - was set up in December 2008 to improve the cardiac surgery patient pathway and help the trust meet the 18-week referral to treatment target. Lead by a cardiothoracic nurse practitioner, who co-ordinates the care of cardiac surgery patients, the service has seen the number of theatre cancellations decrease from 10.1 cases per month two years ago to just 2.3 cases per month at present. Length of hospital stay has also reduced - from 8.8 days to 7.6 days for elective patients, and 15.7 days to 13.3 days for emergencies" - Nursing Times

Revolutionary operation could 'cure' high blood pressure (UK)

A revolutionary new operation which could effectively cure high blood pressure has been developed by scientists, offering hope to hundreds of thousands of sufferers. In what is being hailed as the most exciting development in the field for 50 years, doctors can treat the condition with a simple procedure in under an hour. It could allow some sufferers to come off medication completely and offer hope for those for whom existing treatments have no effect. The technique, which is relatively straightforward and cheap for the NHS, could reduce the risk of a major heart attack or stroke in such patients by half. The Daily Telegraph can disclose that the new procedure, which involves placing tiny burns on a nerve responsible for high blood pressure in some people, has been carried out in Britain for the first time. It is part of an international clinical trial which could lead to the new treatment being offered on the NHS. An estimated 15 million people in Britain suffer from high blood pressure, also known as hypertension - around half of them undiagnosed. About one in 10 sufferers cannot control the condition with medication or cannot tolerate the drugs, leaving them at greater risk. Hundreds of thousands face a lifetime on medication to reduce the risk of suffering heart disease, strokes or kidney failure. Dr Mel Lobo, a specialist in clinical hypertension at Barts and the London NHS Trust, said: "This is the most exciting development in hypertension since the advent of anti-hypertensive medication 50 years ago. 'It is hard to forecast the limitations and it could eventually be compared to medication.' The new procedure, called renal sympathetic-nerve ablation, involves inserting a wire into a blood vessel close to the kidneys to burn through nerves which carry signals that stimulate high blood pressure. It disrupts signals from the brain telling the kidneys to keep blood pressure raised. Initial tests suggest it can be effective within three months. Anthony Henry, 68, a retired chef from Stratford in East London, became the first person in Britain to have the operation. Watched by The Daily Telegraph, the team at the London Chest Hospital carried out the painstaking procedure in just over one hour. Mr Henry, who is diabetic and has already suffered a stroke and a deep vein thrombosis, was awake throughout the procedure and spoke to Prof Martin Rothman, the cardiologist who performed it. He was kept in hospital overnight but it is thought once greater experience is gained with the technique, patients will be able to go home the same day. Mr Henry's blood pressure has already come down, just two weeks after the operation and it is thought most patients will see an improvement within three months. Prof Rothman said: "Patients will be able to walk into the hospital and walk out again the same day. "This relatively trivial procedure has the potential to make a serious improvement to the quality of life for the patient. 'It is very efficient and can lower the blood pressure enough to reduce stroke mortality by 50 per cent.'
It was estimated the procedure could cost the NHS around £4,000 per patient, yet it could prevent significant numbers of strokes and heart attacks saving money on emergency treatment and rehabilitation. Dr Paul Sobotka, chief medical officer of Ardian, an American company which has developed the equipment, said: "For the first time we can think of a cure for hypertension." Mr Henry is one of 110 patients taking part in a trial to evaulate the new technique with half receiving the operation plus their normal medication and the other half only taking their drugs.
Dr David Collier, senior clinical trials fellow at the Biomedical Research Unit at Queen Mary University London, said the operation offers real hope of an alternative to a life on pills for patients whose blood pressure is difficult to control but he warned that it was not the 'lazy person's answer' to diet and exercise. Dr Collier said: "This procedure can bring patients within the normal blood pressure range and may enable some to come off their medication. It is the equivalent of them taking two types of drugs. They could be considered cured, at least in the medium-term and we hope long-term." - Telegraph

1,000th heart surgery performed at Conway Regional, Arkansas

"Martha Matthews of Conway became the 1,000th patient to have open heart surgery at Conway Regional Medical Center last week. Matthews was resting in her room at the hospital on Thursday with her daughter, Zanette Bell of Conway, nearby. Matthews said she had an angioplasty nine years ago and has seen a cardiologist regularly since then. Recently, she and her daughter noticed she was experiencing shortness of breath. Matthews' family doctor referred her to cardiologist Dr. Parker Norris. She had multiple blocked arteries, a narrowing of the aortic valve and atrial fibrillation, she said. On February 24, Dr. E.J. Chauvin performed three bypasses, an aortic valve replacement and an atrial fibrillation procedure on Matthews, who is 81, according to a news release from the hospital. On Tuesday, Chauvin put in a pacemaker" - The Log Cabin Democrat

Baby boy recovering after operation to move heart from wrong side of his chest (UK)

Matthew Molloy, who was born with a "100,000 to one" combination of heart defects which doctors said is only seen every 20 years, had to undergo 11 hours of surgery to correct four separate problems. By the end, his internal organs were so swollen that doctors were unable to close his chest cavity and had to seal it temporarily with a substance resembling cling-film. His parents were able to see his heart beating and lungs expanding inside before he was later stitched up. But the youngster, from Northampton, is now almost six months old and putting on weight after the "miraculous" operation. Tim and Michelle Molloy were celebrating what appeared to a be a perfectly normal and healthy birth when Matthew, their third child, arrived on September 10 last year at Northampton General Hospital. - Telegraph