As Part of "Heart Valve Revolution," A Less Invasive Approach to Replacement Comes to UMMC

For immediate release: August 06, 2015

In January, the University of Maryland welcomed cardiologist Michael Slack, MD, as Professor of Pediatrics at the School of Medicine and Director of Pediatric and Adult Congenital Interventional Cardiology at the University of Maryland Medical Center (UMMC). Dr. Slack brings over 30 years of experience treating patients of all ages with congenital heart problems and recently performed the first successful pulmonary valve replacement using a percutaneous catheter at UMMC.

Thanks to research and treatment advances, more congenital heart disease patients are surviving into adulthood. As such, progressive medical centers across the country are establishing programs like UMMC’s Congenital Heart Program to meet the needs of both pediatric and adult patients. “It became clear that a hybrid program to not only treat pediatric patients but follow them into adulthood was needed,” says Dr. Slack, who established the first such program in the region at MedStar Washington Hospital Center before joining UMMC. “Adult survivors of congenital heart disease have long-term medical needs that we are only now beginning to understand.”

One common intervention for adult congenital heart patients is repeat surgery to replace a heart valve that is no longer functioning properly. This is not unusual as the heart valves in use today are only meant to last about 10-20 years. Patients can also simply outgrow the valves that were placed during pediatric surgery. “As children age, their bodies change and grow. Heart surgery performed on a child poses a whole new set of problems as they reach adulthood,” adds Dr. Slack.

Because patients are living longer, repeat surgeries become riskier each time due to buildup of scar tissue around the heart. But new, non-invasive options such as catheter-based procedures are the wave of the future, says Dr. Slack.

The First of Many

In April, Dr. Slack placed a catheter fitted with an artificial valve into the femoral artery of a young adult patient. She’d undergone a Ross procedure several years earlier, but her “new” pulmonary valve had worn out. In the catheterization laboratory, Dr. Slack slowly guided the catheter to the patient’s heart and fitted the artificial valve into place. There was no need to remove the original valve, as the one Dr. Slack used is designed to fit perfectly inside the defunct valve. Dr. Slack then removed the catheter and observed blood was flowing successfully to the lungs. The entire procedure took less than two hours.

It was the first time a right-sided heart valve had been replaced via catheter at UMMC. UMMC is now one of only two hospitals in Maryland with the expertise to perform this procedure.

“We are in the midst of a heart valve revolution in the United States,” says Dr. Slack. “There are more than 20 valves currently in development and all have the potential to dramatically alter the way we currently care for cardiac patients.”

Standard of care for fixing leaky or malfunctioning valves is open-heart surgery. But catheter-based approaches are becoming more common. These non-invasive procedures are much easier to tolerate. Patients usually leave the hospital in less than 24 hours. Because the non-invasive procedures are performed while the heart is still beating, cardiopulmonary bypass is unnecessary. “Patients can get back on their feet in days not weeks,” adds Dr. Slack.

Dr. Slack’s recruitment is one of many ways the Heart Center continues to innovate and expand its interventional options for both pediatric and adult patients. Catheter-based procedures can also be used to enlarge blood vessels and close residual holes in the heart that have re-opened.