Heart valve repair and replacements are performed for mal-functioning heart valves. The function of the heart valve is to promote the pumping of blood by the heart and make sure the blood flows in the correct direction in the heart. Heart valves may not function if they don’t open/close properly. The types of heart valve defects include a narrowing (stenosis) of a valve or a leak in a valve that allows the blood to back up.
There are 4 heart valves—the aortic, mitral, pulmonary, and tricuspid. Of these valves, the most frequently repaired/replaced are the aortic and mitral valves. Valves are either of biologic origin (porcine/pig) or mechanical (carbon fiber). While the relative advantages of each have been debated in the literature for years, their price points (about $5000) have not varied significantly.
The most significant change is the use of endovascular valve replacement (TVR), pioneered by Edwards Life Sciences, originally approved by the FDA in 2011. Instead of intense open heart surgery with a lengthy recovery, the valve is delivered via catheter through the groin to the heart. This has both reduced the trauma of the open heart surgery, as well as expanded the candidates for the surgery to include those once regarded as too high- risk for open heart surgery. With a price point for an endovascular valve at over $30,000, there has been a great deal of attention to the device, potential benefits, and market expansion.
iDataResearch data from 2017 indicates that about one third of the valve replacements were endovascular (60,000 out of 180,000), although this ratio is expected to expand in future years. Of the top hospitals that perform valve replacements on the Medicare population, some have “fully” embraced the TVR, such as Cedars Sinai, St. Francis Roslyn, and Morristown. These hospitals had over 55% of their valve replacement cases performed endovascularly. Others, such as Cleveland Clinic and the Mayo Clinic had fewer than 30% of their heart valve replacement cases as TVRs.
Download the whole publication here: Curvo Spotlight – Heart Valves Vol 2 No 4
Editor – Stan Mendenhall
Associate Editor – Jake Titzer
Cartoons – Robin Wilt
Annie Gallup – Illustration and Graphic Design
Volume 2, Number 4
December 2019 Publication