NEW ORLEANS: Many people with a bad aortic valve may soon be able to avoid open-heart surgery and have a new one placed through a tube in an artery instead. A study finds that survival after a year is about the same for either way of replacing the aortic valve, which is the main gate for blood leaving the heart. However, more strokes occurred with the artery approach, and the newer valves do not yet have federal approval. Still, cardiologists say that if the new valve wins federal approval, it would prove as popular with patients as balloon angioplasty has for fixing clogged arteries without an operation. “The fact that it's not open-heart surgery sells itself, and the rest gets lost in the mix,” said Dr. Craig Smith, heart surgery chief at Columbia University and New York-Presbyterian Hospital. He led the study and gave results Sunday at the American College of Cardiology meeting in New Orleans. It involved about 700 people, median age 84, who were deemed able to endure surgery but at high risk of complications from such a major operation. Half were given the usual surgery and the others were treated with an experimental valve by Edwards Lifesciences Corp., placed through an artery in the groin or the chest. After one year, about 24 percent of the artery patients and 27 percent of the surgery patients had died — comparable results in a study this size. However, strokes and other neurological problems were twice as common in the artery group — 8 percent versus 4 percent — after one year. Previous studies also found more strokes with the minimally invasive approach. Other complications were a trade-off: Major bleeding and new cases of a fluttering heartbeat called atrial fibrillation were more common with surgery; there were more blood-vessel problems with the artery approach.
