New technique gets around open-heart surgery

When a faulty heart valve started slowing down Lena Downey last year, she didn’t have many options.

Health problems made it risky for the 87-year-old Hale, Mo., woman to have the open-heart surgery that is usually done to install a new artificial valve. And no medication could improve her condition.

So when St. Luke’s Hospital offered her a new investigational procedure to replace her heart valve without cutting open her chest, she was eager to try it.

“I told them they could do whatever they wanted as long as they put me to sleep,” Downey said. “I think it’s wonderful if it helps me get well. That’s all I ask.”

On Wednesday morning, Downey became the first person to undergo the procedure in Kansas City. Later that evening, she was in stable condition at St. Luke’s.

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Even with BMPs, osteoinductive matrices still play a role in spine restoration cases

September 2008

While osteoinductive factors and matrices may be advantageous for spinal fusion, a leading spine surgeon warns about the consequences of using bone morphogenetic proteins in large doses and calls for a re-examination of iliac crest bone grafting.

“Lumbar spine fusion, especially posterior lumbar spine [fusion], continues to present a difficult clinical problem,” Harvinder S. Sandhu, MD, said. “Although BMPs are powerful and useful biologic tools, do not underestimate the risks when using supraphysiologic doses. There is an inflammatory and osteolytic host response in some cases and, in the spine, chronic radiculitis. Well-designed osteoconductive matrices and local bone graft and bone marrow still have an important role.

“I think that we have to revisit the whole issue of iliac crest bone grafting, particularly in light of the newer, less invasive bone harvesting methods that are now available. It ultimately may be a safer and more cost effective method, even when combined with osteoconductive matrices,” he said.

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