John Carroll MD
The University of Colorado is a national leader in the percutaneous and surgical management of complex structural heart disease. It is obvious that this broad area of investigation is becoming an increasingly important area of in the field of cardiac intervention and we are delighted to have become an established national leader. The program at UCH is multidimensional but relies on a team approach that includes cardiac interventionalists, cardiac imaging specialists and cardiac surgeons as well as a dedicated team of nurses and skilled technicians. The program is largely referral based so seamless communication between our faculty and referring physicians is critical.
Signature components of the program include percutaneous closure of PFO, ASD, VSD and perivalvular leaks as well as mitral and aortic valvuloplasty. We are far and away the highest volume center in the region for all of these procedures and we are among the highest volume centers in the nation. The indications for several of these therapies are in evolution so we have been involved (and have taken the lead) in a number of multi-center trials and as a result many patients may qualify for consideration of enrollment in on-going clinical studies Experimental devices can also be deployed on compassionate care protocols and those devices that already have FDA approval are also available. Patients being considered for a percutaneous repair procedure will undergo a thorough clinical evaluation (which his many cases may include non-invasive 3D reconstruction) to determine suitability and also to optimize the chances of a successful outcome. Both aortic and mitral valvuloplasty are routinely performed, and offer patients a meaningful alternative to more conventional (and occasionally prohibitively risky) surgical procedures.
We have also been national leaders in both surgical and percutaneous valve repair. Our surgeons (and in particular David Fullerton, Chief of Cardiac Surgery) are skilled in surgical mitral valve repair and the often linked Maze procedure. Percutaneous valve repair is also available for selected patients and UCH was one of the leading recruitment sites for the recently concluded E-valve trial which compared a percutaneous valve clip procedure with an open procedure (see picture above). The results of this trial are currently in front of the FDA and we anticipate that approval of the E-valve device is imminent which will allow highly selective centers (including UCH) to expand the use of this therapy. We also anticipate beginning to enroll patients in percutaneous aortic valve replacement (TAVI) trials in the next several months.
As should be evident from the above brief overview, a cutting edge program in structural heart disease requires outstanding working relationships between cardiac surgery and interventional cardiology as well as superb cardiac imaging technology and we are fortunate that this interactive culture and technologically robust infrastructure is present at UCH. Our 3-D cardiac reconstruction program is a major strength and is a truly research unique component of the overall structural heart disease program. In addition, a program of this nature requires strong partnerships with industry and we have a long-standing research relationship with Phillips that has helped maintain UCH at the forefront of technologic innovation and in addition we have been (and continue to be) leaders in the design and execution of multi-center research protocols that have been critical to recent advances in the field.
For further information or to schedule a patient for evaluation: (720) 848-6556