Mount Sinai Heart Institute

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The Best Today and In the Future in Treating Valve Disease

Heart valve disease affects millions of Americans each year. At the Mount Sinai Heart Institute, in partnership with New York's Columbia University, patients have access to the most innovative and revolutionary surgical options for treating valve disease.

Great advances have been made in minimally invasive valve surgery, and Dr. Joseph Lamelas, chief of cardiac surgery at Mount Sinai, is on the leading edge. Board-certified in cardiac and thoracic surgery, as well as surgical critical care, Dr. Lamelas pioneered an advanced one-man surgical technique for minimally invasive valve procedures. He teaches this method to surgeons across the United States and around the world.

Dr. Lamelas consistently has had one of the lowest morbidities and mortalities in Florida and the United States, and he is South Florida's most experienced surgeon in his area of expertise. In fact, the Mount Sinai Heart Institute performs more valve procedures than any other hospital in Florida, and has South Florida's best survival rates for complex, large-volume cases, according to the Florida Agency for Health Care Administration.

"When selecting a surgeon, it's important to know the surgeon's level of experience and results," Dr. Lamelas said. "Our surgical volume assures patients that we have the experience of working on varied cases and our low morbidity and mortality levels are unmatched in the region."

Unlike open-heart procedures, which require a 12-inch incision through the sternum, minimally invasive surgery is done with a two-inch incision between the ribs on the side of the chest. With minimally invasive valve surgery, patients experience:

Dr. Lamelas' technique offers advantages to both patient and surgeon. Small incisions make minimally invasive valve surgery technically challenging. Multiple surgeons limit exposure and create the potential for complications while having a single surgeon perform the procedure allows better access and visualization.

Dr. Lamelas, who has developed his own instruments to facilitate minimally invasive cardiac surgery, is constantly advancing his craft.

"We are continuously searching for innovative minimally invasive techniques to treat valve disease," Dr. Lamelas said. "While others are comfortable with the tried and true, we know there is more ground to cover in making the treatment even less invasive and, as a result, more beneficial for our patients."

In addition, new ground-breaking research at Mount Sinai has shown that elderly patients who had minimally invasive valve surgery had an increased survival rate, fewer postoperative complications, and a shortened length of hospital stay, compared with the traditional open-heart approach. Overall, the results demonstrated that minimally invasive valve surgery is feasible and should be considered for older patients.

"The implications of this study are huge," Dr. Lamelas said. "Basically, at Mount Sinai, we can now prolong life expectancy in a population that, otherwise, was not given the interventional care they needed because they were labeled as high-risk patients. Elderly patients with heart disease need to know that they do have options for surgical intervention."

Articles

Mount Sinai Medical Center Selected to Participate in CoreValve® Clinical Trial

(June 3, 2011 - Miami Beach, FL) - Mount Sinai Medical Center in Miami Beach, Florida announced its participation in the Medtronic CoreValve U.S. Clinical Trial, which will evaluate a new, non-surgical alternative to open-heart surgery for patients with severe aortic stenosis. Mount Sinai is now among a select number of leading hospitals across the U.S. to participate in this trial.

"We're excited to partner with other leading cardiac specialists in the U.S. to study this revolutionary technology," said Dr. Joseph Lamelas, Chief of Cardiac Surgery at The Mount Sinai Heart Institute. "The boundaries of medical treatment are constantly being expanded, and Mount Sinai is proud to stand with our patients on that frontier."

The CoreValve System is designed to provide a minimally invasive, non-surgical treatment option for patients with symptomatic, severe aortic stenosis who are at high risk, or are ineligible, for open-heart surgery. Worldwide, approximately 300,000 people have been diagnosed with this condition (100,000 in the U.S.), which occurs when the heart's aortic valve is narrowed, restricting blood flow from the heart to the body. Approximately one-third of these patients are deemed at too high a risk for open-heart surgery as the condition typically affects an older demographic and develops in individuals between the ages of 50 and 70. The Medtronic CoreValve U.S. Clinical Trial will evaluate the safety and effectiveness of the CoreValve Transcatheter Aortic Valve System in these groups of patients.

"The procedure we are evaluating does not require open-heart surgery or surgical removal of the native valve, which makes this potential treatment option especially desirable because so many patients with aortic stenosis are not able to withstand surgery," said Lamelas.

The Medtronic CoreValve System is a new technology designed to replace a diseased aortic heart valve percutaneously – meaning through the skin – without open heart surgery and without surgical removal of the diseased valve. The new valve replacement procedure channels a catheter (thin tube) with a prosthetic valve through the femoral artery to reach the heart. The CoreValve System is designed with self-expandable technology, deploying the new valve inside the diseased aortic valve without open-heart surgery or surgical removal of the native valve.

The Medtronic CoreValve U.S. Clinical Trial will enroll a total of more than 1,200 patients at 40 U.S. clinical sites, including Mount Sinai Medical Center. Outside the U.S., CoreValve received CE (Conformité Européenne) Mark in Europe in 2007.

Mount Sinai Medical Center is currently enrolling patients in the trial. For more information about participating in this clinical trial, contact at 305-674-2399.

Minimally Invasive Valve Surgery Benefits High Risk Elderly Patients

Study Finds Outcomes Superior To Standard Breastbone-Splitting Surgery
by Kathleen Corso

POSTED: Friday, January 14, 2011
UPDATED: 4:59 pm EST January 14, 2011

MIAMI BEACH, Fla. -- The Annals of Thoracic Surgery recently published a study conducted at Mt. Sinai Medical Center on Miami Beach involving 203 patients age 75 or older who needed heart valve replacement surgery.

"We wanted to compare the outcomes of a minimally invasive valve repair compared to a traditional surgery where the breast bone is opened," said Dr. Joseph Lamelas, Chief of Cardiac Surgery at Mt. Sinai.

Of the 203 patients, 84 got the traditional procedure, while the remaining 119 got the minimally invasive cardiac surgery, which is done through a 2-inch incision on the right side of the chest.

"Studies have been done comparing the two procedures before, but only on a younger patient population," said Lamelas.

The study found that patients who got the minimally invasive procedure had fewer complications during the procedure, a dramatically lower risk of kidney failure following surgery, a lower rate of wound infection, and shorter hospital stays.

"This is challenging the conventional wisdom that these patients are too old to undergo valve surgery, that they must simply live with their condition and accept diminished quality of life," said Lamelas.

Published Studies

Patient Education

Online patient education videos for cardiovascular procedures and conditions including:

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