Replacing a Faulty Heart Valve Without Surgery

Newly approved transcatheter pulmonary valve offers alternative to repeated open heart surgeries in kids — and adults — with congenital heart defects

Like a lot of children with congenital heart defects, Christian Encizo faced the prospect of multiple open heart surgeries throughout his life. He was born with pulmonary stenosis, a faulty valve linking the right ventricle of the heart and the lungs.

At age 6, he had his first major operation to replace the bad valve with an artificial one.

Earlier this year, Christian, now 11, began getting tired and short of breath. The old valve was beginning to leak and needed to be replaced. But rather than undergo another open heart surgery, Christian now had an alternative, his doctors at University Health System said.

On May 13, Christian had a new valve implanted using a catheter that is inserted through a small incision and threaded to his heart. Christian — a fifth-grader and diehard San Antonio Spurs fan — returned home to El Paso a day later.

“We’re really, really happy,” said his father, Oscar Encizo. “This is a breakthrough. It’s 100 times better than open heart surgery.”

Dr. Christopher Curzon, assistant professor of pediatrics at the UT Health Science Center and medical director of the Pediatric and Congenital Interventional Catheterization Program at University Hospital, said the Melody transcatheter pulmonary valve can benefit patients with a number of different congenital heart defects. The device received full approval from the FDA in January.

“Those surgically-placed valves can last six months, or they can last a decade or more. But the bottom line is, these kids need multiple surgeries — sometimes three or four surgeries by the time they’re 11 years old,” Dr. Curzon said. “It’s a big operation, not just a little thing. So the opportunity to be able to go in and replace the valve through a little tiny incision in the groin versus an open heart surgery is an incredible opportunity for these families, and it’s wonderful for these kids.”

The transcatheter valve is made from a cow’s jugular vein sewn into a metal stent, which is then inserted using a balloon catheter. Once in place, the balloon is inflated, installing the valve.

The procedure doesn’t eliminate open heart surgery completely, Dr. Curzon said. The patient generally requires a surgically-implanted valve already in place. When that begins to fail, the transcather valve is implanted inside the old valve.

But the hope is that the transcatheter valve can delay or reduce the number of open heart surgeries for patients, since each open heart surgery leads to more scar tissue and a higher risk of more surgeries.

“If you can eliminate one or two of those surgical interventions, that’s a huge deal to these patients,” Dr. Curzon said.

It’s not just children who benefit. Rochelly Torres, a 40-year-old San Antonian born with a congenital defect called tetrology of Fallot, had three open heart valve replacements beginning at age 6. The last one was in 1997.

She underwent the transcatheter valve procedure the same day as Christian’s, and was discharged two days later. Typically, open heart surgery patients are in the hospital three to eight days.

“I feel less fatigue. I can walk more now,” Ms. Torres said. “I have four kids and three grandkids. My husband, my mom – everybody was there at the hospital with me. The whole family was happy with this new thing.”

For more information about the Melody transcatheter pulmonary valve, call the South Texas Pediatric Congenital Heart Center at University Health System at 210-341-7722.