“Cardiovascular medicine is changing rapidly,” says Ryan Kaple, MD, an interventional cardiologist at Yale Medicine. He credits much of these changes to new availability of catheter-based procedures to repair and even replace valves, often without the need for open heart surgery.
The field of cardiovascular medicine is changing rapidly and a lot that is due to advancements in these catheter-based techniques. Catheters are inserted into blood vessels and they are long flexible tubes, almost like straws that can make their way up to the heart structures and allow us to deliver devices to the heart. Through catheters we can fix arteries in the heart. We can close abnormal holes in the heart and really only recently have been able to repair and replace heart valves using catheters.
It's remarkable the change and innovation that has happened.
Valves have 2 main purposes, they need to open to allow blood to leave the heart and they need to close to prevent the blood from flowing backwards through the heart.
My area of interest is primarily the mitral valve. The most common problem with the mitral valve is that it doesn't close properly, and the blood will leak backwards. The mitral valve has a very large range of pathologies and so this spectrum of disease really make it a challenge to tailor therapy for individual patients and that's really the benefit of being at a place like Yale with a lot of options when it comes to innovative clinical device trials.
This allows us to offer procedures and techniques to patients that potentially would not have any other options. The main device that we use to repair mitral valves is the mitral clip.
We also have a research trial called APOLLO. We are one of the few sites in the country that can offer this valve as we've proven that these devices are safe and effective. We've done trials in patients who are lower risk for surgery and so the patient population that we can offer these procedures, too is evolving. Yale is one of the highest volume structural hard programs in the country and what that means for patients is that we are able to push the fundamentals and the innovation of this procedure and these devices forward the procedures that we are doing to replace the valve will become faster, safer for patients. And more effective and to treat a broader range of patients.
I think when we look back 10 years, a lot of us never even envisioned that we'd have the devices at our fingertips that we have, and so we are excited as a structural heart team to see how these devices and procedures will change and develop, and how it will have a huge impact on patients’ lives.