Surgeons at PinnacleHealth CardioVascular Institute, in Central Pennsylvania, are successfully performing a new procedure that may change the way aortic valve disease is treated. Instead of using prosthetic valves, three patients have undergone aortic valve reconstruction — a process that uses the patient's heart tissue (pericardium) to create the new valves.

Dr. Mubashir Mumtaz, Fellow of the American College of Surgeons, Fellow of the American College of Cardiology, chief of cardiothoracic surgery and surgical director of the structural heart program at PinnacleHealth, acknowledges certain challenges during surgery, such as sizing the leaflets precisely, and sewing them so they match and come together perfectly without resulting in leakage from the valve.

“The procedure is longer than replacing the valve with a prosthetic valve so you have to be very efficient in the operating room, so as to not prolong the operation which could be detrimental to the patient,” Dr. Mumtaz told HCB News.
Typical aortic valves have three flaps, or leaflets, that regulate blood flow by opening and closing, but for those with aortic valve disease, these flaps do not function properly.

Aortic valve reconstruction, which repairs the patient’s own valve to restore it to full function, can benefit patients who use their own pericardial tissue since there is a lesser chance of scarring or calcifying, which is the main reason for failure of tissue valves taken from animals.

The body is also less likely to reject the patient’s own tissue, and additionally, blood thinners, which are required for those with mechanical aortic valves, are not needed.

According to Mumtaz, the patients are doing well three months post-surgery.

In the beginning of 2015, Mumtaz visited Professor Shigeyuki Ozaki in Tokyo, who developed the procedure, and observed Ozaki perform two surgeries.

“It was an excellent trip, where I was able to observe two surgeries and was able to do an animal lab with him, where I was able to perform the procedure myself,” Mumtaz said.

In the video below, watch Professor Ozaki perform the surgery.


November of 2015, PinnacleHealth enrolled the first patient in Pennsylvania in a randomized trial studying a new heart valve, Direct Flow Medical system, that conforms to the patient’s anatomy with a double-ring, polymer-based frame.

Additionally, in March of this year, the institute enrolled two patients in a Medtronic-sponsored study that compares transcatheter aortic valve replacement (TAVR) to open surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis who are considered low risk for surgery. The study is the first clinical trial to examine the effectiveness of catheter-based treatment in the low-surgical-risk population.

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