October 29, 1996
Media Contact: John Cramer
Phone: (410) 955-1534
FDA Approves "Port-Access" Method
Johns Hopkins surgeons have begun performing a revolutionary method of minimally invasive heart surgery designed to make patients' recovery easier and reduce costs.
Following recent FDA approval, Hopkins and five other medical centers across the nation started performing -- and soon will train other surgeons to perform -- the new technique called Port-Access for single-graft coronary artery bypasses and heart valve replacement and repair.
In traditional open-heart surgery, the breast bone is split open. But in the new method, surgeons operate endoscopically through several small incisions in the chest wall. Through "ports" between the ribs, a catheter to the heart delivers a drug to stop its beat and a balloon that expands in the aorta and blocks blood flow. A heart-lung machine then is attached -- far less invasively than in traditional surgery -- at the leg's femoral artery, rather than at the heart, to take over the body's circulation. For bypasses, surgeons then take a replacement artery from another part of the body and sew it to the coronary artery below the blockage, restoring blood flow to the heart.
The method is designed to reduce trauma, complications and pain, resulting in shorter hospital stays, quicker recovery times and less cost, says Scott Stuart, M.D., an associate professor of cardiac surgery who leads the training program in the new method at Hopkins. Patients should be able to return to work within two to three weeks, rather than the two to three months required for standard bypass, says Stuart.
Of the 1,200 bypasses performed each year at Hopkins, 40 to 50 involve one graft. But Stuart says the procedure should be available within 12 to 18 months for double and triple bypasses.
The bypass and valve systems, developed by Heartport, Inc., include specially designed microsurgical tools and a miniaturized video camera that provides magnified, three-dimensional images. The systems will be available commercially in the United States next year after enough surgeons are trained.
The leading cause of death in the United States, coronary artery disease affects about one in three Americans, costing an estimated $38 billion in health care bills.
Other centers in the clinical training program are Barnes-Jewish Hospital at Washington University in St. Louis, Brigham and Women's Hospital in Boston, the Cleveland Clinic Foundation in Cleveland, New York University in New York City and Stanford University in Palo Alto, California.
Hopkins cardiac surgery faculty members also have been successfully performing another type of minimally invasive coronary artery bypass surgery for the past year at Sinai Hospital in Baltimore. This method also is done through small incisions, but the heart continues to beat.