Joseph Krinsky and his wife, Emily, were wintering in Miami Beach when he learned that he needed to have his aortic valve replaced due to aortic valve stenosis.
His doctor back home in Michigan told him that a new nonsurgical valve replacement procedure was too risky to try because it was still under clinical trials, but Krinsky decided to follow his heart. Believing in the expertise of his doctors at Mount Sinai Medical Center, he chose to undergo the procedure.
“I decided Mount Sinai was the best place for older people,” said Krinsky, who was 84 years old when he had the procedure in February 2013. “They had the most experience.”
At the time, Mount Sinai was one of only 45 sites in the United States participating in the Medtronic CoreValve U.S. Pivotal Trial, a landmark study focusing on high-risk patients – those predicted to have more than a 15 percent chance of death from open-heart surgery within 30 days.
Results from the study were so positive that in January 2014, less than one year after Krinsky’s procedure, the U.S. Food and Drug Administration (FDA) approved the procedure for extremerisk patients, giving many people a safer alternative to open-heart surgery.
The American Heart Association estimates that more than 5 million Americans are diagnosed with heart valve disease every year. Aortic stenosis is a common problem caused by a narrowing of the heart’s aortic valve due to excessive calcium deposited on the valve leaflets. When the valve narrows, it does not open or close properly, making the heart work harder to pump blood throughout the body. Eventually, this causes the heart to weaken and function poorly, which may lead to heart failure and increased risk for sudden cardiac death.
Essentially a stent with a valve sewn into it, the CoreValve System is delivered to the heart via a catheter that is passed through a small incision in the groin area and guided through the arteries to the site of the diseased valve. Once in position, the CoreValve expands into the place of the diseased valve and takes over its function. Patients who participated in the study experienced significant improvements in their quality of life. In addition, they had fewer complications, shorter hospital stays and quicker recoveries.
Nirat Beohar, M.D., director of the cardiac catheterization laboratory at Mount Sinai Heart Institute and a member of the Columbia University Division of Cardiology at Mount Sinai, performed Krinsky’s procedure, with outstanding results.
“I had the surgery on Monday and I went home that Wednesday,” Krinsky said. By the following Monday, he was back on the treadmill, walking for 30 minutes. Within a few more days, he was back to his regular routine. “I always go to the gym about five or six times a week,” he said. “I walk three and a half miles on the treadmill and then I stretch for 20 minutes.”
In addition to the nonsurgical Medtronic CoreValve system for valve replacement, the Mount Sinai Heart Institute offers an advanced minimally invasive procedure perfected by Joseph Lamelas, M.D., chief of cardiac surgery. Dr. Lamelas performs more valve surgeries than any other physician in Florida and offers patients among the best survival rate in the country. His minimally invasive valve procedure is done through a two-inch incision between the ribs on the side of the chest. This approach provides much more stability to the chest wall and is more beneficial to the patient. There also is minimal scarring with this technique, and patients generally stay in the hospital for four days, as opposed to two weeks of recovery for open-heart surgery.
To learn more about minimally invasive heart surgery at the Mount Sinai Heart Institute, visit www.miamicardiology.com or call 305.674.CARE (2273) for a physician referral.
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