The Next Big Thing in Cardiology
The University of Chicago Medical Center recently posted on its website an interesting and poignant story about a patient named Geraldine Roman. It's a story about how technology can do more than make things more convenient, efficient, or interesting – it can actually perform the noble work of saving lives.
At age 73, Mrs. Roman was diagnosed with aortic stenosis, a condition in which the heart's aortic valve – meant to open and close with each heartbeat – becomes stiff and narrow, obstructing the outflow of blood from the heart.
The condition develops slowly over the years, but once chest pains appear, more than half of patients die within five years if not treated. Once syncope (fainting spells) appears, most untreated patients have no more than two years left to live.
The traditional treatment for aortic stenosis is open-heart surgery. During this procedure, the patient's breastbone is sawed open, and a heart-lung machine takes over the blood circulation function. The aortic valve is then removed and replaced with an artificial valve. Though successful open-heart surgery produces substantial improvement in aortic stenosis patients, it's an invasive procedure that carries some significant risks. Consequently, not everyone is a candidate for open-heart surgery.
That was the case with Geraldine Roman. Over the years she had accumulated "a huge bundle of co-morbidities," including diabetes, asthma, rheumatoid arthritis, obesity, and chronic back pain. To make matters worse, she had recently fallen and broken her hip.
Given all these medical problems, Roman was deemed inoperable. A few years ago, this would have amounted to something akin to a death sentence. But now, Roman and many others who suffer from aortic stenosis and who would otherwise be out of options have a new lease on life, thanks to an engineering marvel that is shaking up the world of cardiology.
One Giant Leap in Cardiology
In 2011, the FDA approved an alternative and minimally invasive procedure for aortic heart valve replacement, called transcatheter aortic valve replacement (TAVR). And now, new and improved TAVR procedures are in the works.
Cardiothoracic surgeon and television personality Mehmet Oz calls TAVR "a complete paradigm shift" and the cardiologic equivalent of "landing a man on the moon." Cardiologist Eric Topol is equally enthusiastic, calling TAVR "a major step forward" and a "life-changer for many patients."
The innovative procedure allows for the installation of an artificial heart valve by means of a catheter. The catheter is inserted into an artery that is accessed through a small incision in either the patient's groin or chest. It is then snaked through the artery until it reaches the heart and delivers the attached artificial valve for implantation.
Source: Stony Brook School of Medicine
TAVR not only avoids the need to open the chest wall, it can also minimize complications associated with general anesthesia, since TAVR can, if necessary, be performed under local anesthesia.
Due to the less-invasive nature of the new procedure, what was a six-hour open-heart operation plus two weeks in the hospital is reduced to about a two-hour procedure with a much shorter hospital stay.
In Mrs. Roman's case, it took just a few days to get her back on her feet. Afterward, a grateful and plucky Mrs. Roman said, "I felt better the moment I woke up. My heart's OK. Now, what can we do about this back pain?"
TAVR Is About to Take Off
Cases like this will become more and more commonplace in the years ahead. Heart disease is a global pandemic, which increases its cause-of-death share each year. That's mainly because cures and treatments for other diseases are extending people's lives into their 60s and 70s, which is when they are more likely to encounter heart disease. Why? Because heart disease, to a great extent, is a consequence of aging… something that, unfortunately, can't be cured. Consider these facts:
- On average, men in the US have their first heart attack at age 66, women at age 70.
- 40% of all people with heart disease are over age 65, even though they represent only 14% of the overall population.
- With each decade of life, the risk of heart attack increases about threefold.
It's official: as we grow older, the heart starts to wear out. Go figure.
The correlation between age and heart disease is important because we are in an era when the world's population is not only growing, but also aging. According to a study conducted by the United Nations Population Division, "The older population is growing faster than the total population in practically all regions of the world …. Currently, the growth rate of the older population (1.9%) is significantly higher than that of the total population (1.2%)."
While a difference of 0.7% may not sound like much, consider the dramatic effect it will soon have on global demographics: In 2012, the world's age 65-plus population was 560 million; within ten years, it will be an estimated 675 million.
The implications are clear. As the population ages, the prevalence of heart disease will increase, including valvular heart disease. According to a study by V.T. Nkomo, a Mayo Clinic doctor, about 9% of those between the ages of 65 and 74 have moderate to severe valvular heart disease; for those 75 and older, the percentage jumps to 13%.
Because the elderly are frequently frail, many of these people are inoperable or high risk. However, with the advent of TAVR, they are now candidates for aortic valve replacement.
Though TAVR's current indication is for inoperable and high-risk patients, as the technology advances it could someday become the standard for replacing heart valves, even for low-risk patients. After all, who wouldn't opt for a minimally invasive procedure so long as it is as safe and effective as the conventional approach?
To say the least, this is an exciting technological advancement in the field of medicine. Make no mistake about it, it will make its mark in the medical arena in the coming years. Of course, this begs the question: as an investor, how do you play this powerful and exciting secular trend? To find out, I suggest you sign up for the BIG TECH family, as we have identified the one company that is currently in the best position to benefit from the TAVR trend.
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