Members of St. Luke’s University Health Network Structural Heart Program were among the first in Pennsylvania to use the Pi Cardia ShortCut device, an innovative technology designed to make certain high-risk heart valve procedures safer and more predictable.

The ShortCut device was used during a valve in valve transcatheter aortic valve replacement (TAVR) in a patient with a previously implanted surgical bioprosthetic aortic valve.

If a patient’s initial valve replacement begins to reach end-of-life, this procedure is done to place a new valve over top of the existing one by a catheter inserted via a small incision in the patient’s groin.

The procedure was performed by Christopher Sarnoski, DO, Section Chief of Interventional Cardiology and Medical Director of Structural Heart Disease, and Jose Amortegui, MD, Chief of Cardiac Surgery.

“This device represents a major step forward in protecting patients with complex anatomy. It allows us to safely treat individuals who previously had no good options often involving redo open heart surgery,” said Dr. Amortegui.

Patients who have undergone open heart surgery to receive a tissue (bioprosthetic) aortic valve often require another valve procedure years later when the first valve wears out. A valve in valve TAVR is a minimally-invasive way to treat this without repeating open heart surgery.

However, some patients have what is known as low coronary height, meaning their heart’s coronary arteries sit very close to the valve. In these situations, when a new valve is placed inside the old one, the old valve’s leaflet can be pushed upward and block blood flow to the coronary arteries. This can be dangerous and potentially life threatening.

The ShortCut device is designed to gently open the old surgical valve’s leaflet before the new valve is implanted. By precisely splitting the leaflet, ShortCut helps:

• Prevent the leaflet from blocking coronary arteries

• Make valve in valve TAVR safer for patients with low coronary height

• Offer a minimally invasive alternative to repeat open heart surgery

“Before ShortCut, the only other options for these high risk patients were a redo sternotomy, which carries significantly higher surgical risk, or placing stents in a snorkel fashion out into the aorta, which further limits repeat coronary procedures,” said Dr. Sarnoski. “ShortCut provides a safer and more durable solution for many of these complex cases.”

Experts estimate that by 2035, more than 40,000 valve in valve procedures will be performed in the United States each year. A significant portion of these cases will require leaflet modification technologies like ShortCut to ensure safe coronary blood flow.

Information about St. Luke’s heart valve program: sluhn.org/heart