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Percutaneous Edge-to-Edge Mitral Valve Repair
Shows Favorable Preliminary Results
Cath Lab Procedure Could Replace Major Heart Surgery in Some Patients
(Philadelphia, PA and New Orleans, LA) – The Hospital of
the University of Pennsylvania (HUP) is participating in a nationwide
clinical trial of a new valve repair device that could replace major heart
surgery in some patients. A tiny clip – delivered by a catheter
and deployed in the heart to repair a malfunctioning and leaking mitral
valve – is building a favorable safety and feasibility profile as
the EVEREST Phase I clinical trial nears completion.
Severe mitral valve regurgitation (MR) is a debilitating condition that
causes shortness of breath, fatigue and palpitations. In the United States,
about 250,000 people develop significant MR each year, with almost 50,000
requiring surgery. The clip is designed to secure the valve’s leaflets
near the center of the valve so that blood leakage is minimized and the
heart pumps more efficiently. This new device could decrease a patient’s
hospital stay, result in fewer complications, provide a quicker recovery
time, and significantly reduce health care costs. "In my most recently
treated patient, we utilized two clips to reduce his MR from severe to
mild. It has been six months since his procedure, and he has no symptoms
whatsoever,” says Howard C. Herrmann, MD, Director
of Interventional Cardiology & the Cardiac Catheterization Laboratory
at Penn, and principal investigator for HUP’s component of the EVEREST
Trial.
“The development and clinical evaluation of this device are paving
the way for percutaneous, or through the skin, valve repair. We are at
the beginning of an exciting new avenue in interventional cardiology.
I have no doubt that in five or ten years, interventional cardiologists
will be routinely treating valvular heart disease in many patients without
cardiac surgery,” adds Dr. Herrmann.
To date, a total of 24 patients who suffered from significant MR have
received the clip as part of the EVEREST I clinical study under an FDA-approved
investigational device exemption (IDE). The clip is a product of Evalve
Inc., a medical device company, and the sponsor of the trial. Based on
these promising results, a larger, Phase II safety and efficacy trial
may be initiated later this year.
Dr. Herrmann presented an update of the trial’s findings today at
the American Heart Association’s Scientific Sessions 2004 in New
Orleans during a presentation entitled “Percutaneous Edge-to-Edge
Mitral Valve Repair: Preliminary Results of the EVEREST- I Study.”
To be eligible for the investigational procedure, candidates must have
moderate-to-severe or severe MR and be experiencing symptoms (fatigue,
chest pain, shortness of breath); or, lacking these symptoms, they must
have a weakened left ventricle (heart muscle).
Performed in the cardiac catheterization lab, the initial procedures have
taken approximately two to four hours. Under full anesthesia, a catheter
(a thin, flexible plastic tube) is introduced through the skin in the
thigh area and guided through the femoral vein to the affected area of
the heart. A smaller delivery catheter that holds the clip is slipped
through this tube so that the clip can be guided into place and attached
to the leaflets (the “swinging doors”) of the mitral valve.
Once the clip is attached, the delivery catheter is removed. The entire
process is monitored by an echocardiogram. The hospital stay has generally
been two nights; and most patients returned to normal activity within
one week.
Other investigators contributing to this study are Ted Feldman, MD, Evanston
Northwestern Healthcare System; Hal Wasserman, MD, Columbia University
Medical Center; William Gray, MD, Swedish Medical Center, Seattle; Peter
Block, MD, Emory University Hospital and Patrick Whitlow, MD, The Cleveland
Clinic Foundation.
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Caution: Investigational Device. Limited by Federal
(US) Law to Investigational Use
Editor’s Notes: Dr. Herrman receives research funding from
Evalve Inc.
PENN Medicine is a $2.7 billion enterprise dedicated
to the related missions of medical education, biomedical research, and
high-quality patient care. PENN Medicine consists of the University of
Pennsylvania School of Medicine (founded in 1765 as the nation’s
first medical school) and the University of Pennsylvania Health System
(created in 1993 as the nation’s first integrated academic health
system).
Penn’s School of Medicine is ranked #3 in the nation for receipt
of NIH research funds; and ranked #4 in the nation in U.S. News &
World Report’s most recent ranking of top research-oriented medical
schools. Supporting 1,400 fulltime faculty and 700 students, the School
of Medicine is recognized worldwide for its superior education and training
of the next generation of physician-scientists and leaders of academic
medicine.
Penn Health System is comprised of: its flagship hospital, the Hospital
of the University of Pennsylvania, consistently rated one of the nation’s
“Honor Roll” hospitals by U.S. News & World Report; Pennsylvania
Hospital, the nation's first hospital; Presbyterian Medical Center; a
faculty practice plan; a primary-care provider network; two multispecialty
satellite facilities; and home health care and hospice. |