From performing the first heart transplant in the nation’s capital to perfecting the most popular implanted heart pump in the world today, MedStar Washington Hospital Center has been synonymous with innovation for nearly 60 years. Now, its physicians and researchers are paving the way for even better patient care and outcomes in the future…here and everywhere.
Small Devices, Big Results
In 1988, the Hospital Center became one of the first three hospitals in the United States to implant a left ventricular assist device (VAD). Ever since, it’s been front and center in the march to perfect the technology and reduce both deaths from end-stage congestive heart failure (CHF) and reliance on heart transplant.
Easier Treatments for Patients
When the Hospital Center first performed TAVR (transcatheter aortic valve replacement) as part of a nationwide clinical trial in 2010, the investigational device was revolutionary, a breakthrough approach that proved to extend life and its quality for frail, elderly or otherwise inoperable patients. Its success opened the floodgates for a wave of other innovative technology and techniques that can fix faulty valves while sparing patients the rigors of open-heart surgery.
“Today, we’re on the cusp of a new era in treating structural heart disease through less invasive means,” says Lowell Satler, MD, director, Cardiac Cath Lab. “Our experience with combining interventional cardiology, surgical and imaging techniques shows that we can often use a catheter-based strategy and get the same result as a standard open-chest operation.” Dr. Satler and his colleagues are participating in multiple clinical trials to test the newest hybrid therapies for valvular abnormalities:
- Trialign Transcatheter Repair for Tricuspid Regurgitation. Researchers are studying Trialign’s ability to reduce leakage by percutaneously implanting anchors in the valve and cinching them closed, effectively transforming a tricuspid valve into a bicuspid one.
- Tendyne. MHVI at the Hospital Center is one of six centers evaluating this new transcatheter-based mitral valve repair that approaches its target via a small opening in the bottom of the heart, avoiding a sternectomy and cardiopulmonary bypass.
- MITRAL. Accessed through the carotid or femoral artery, MITRAL deposits a supplemental valve in the malfunctioning mitral valve as an alternative to open-heart surgery. Ten sites are examining its effectiveness.
- MitraClip®. FDA- and CMS-approved for high-risk, non-surgical patients, MitraClip is now under study to determine its effectiveness as a treatment for heart muscle dysfunction.
MHVI also recently launched the first multi-institutional, clinical trial in the nation to evaluate the benefits of using TAVR in low-risk patients. “Around 75 to 80 percent of all aortic valve replacement surgeries today occur in this group,” Dr. Satler says. “If TAVR’s outcomes and long-term durability continue on the current trajectory, we could see this approach overtake open-heart surgery for the majority of aortic stenosis patients in the near future.”
Healing the Heart: 3-D Models & Stem Cells
“MHVI has always been at the forefront of novel, innovative drugs, technologies and cardiac devices, including heart models from 3-D printers,” concludes Ron Waksman, MD, director of Cardiovascular Research. “With more than 100 ongoing basic, clinical and translational trials, we’re better positioned than ever to help change the course of cardiovascular care.”
Dr. Waksman says,”3-D printing helps cardiologists better understand the anatomy of the heart especially in complex cases, and can help communicate to patients about their disease and how therapy will work. In complex cases, cardiologists can look at the anatomy of the heart in detail from different angles, touch it, and discuss the anatomical positions of the vessels, and select the right devices and strategy for treatment. We still use 2-D images, but it is time to open the door for 3-D imaging and printing.”