Heart researchers replace blocked vessels by growing new ones
Valve repair also encouraging, doctors sayNovember 9, 1998
Web posted at: 9:35 p.m. EST (0235 GMT) In this story:
DALLAS (CNN) -- Doctors and researchers meeting at the American Heart Association's annual conference are considering an experimental treatment called angiogenesis, in which scientists use either medication or gene therapy to grow new blood vessels in the heart.
As with most experimental treatments, researchers caution that it's still too early for heart patients to get excited about the process.
But some patients already have experienced positive results.
Take real estate developer Gil Gilman.
"I could not walk across the street without suffering heart pains or angina," Gilman said. Standard drug treatments, bypass surgery and angioplasty were not successful in ending his pain.
Then doctors at Emory University in Atlanta offered Gilman angiogenesis. Since the treatment, Gilman said, he's gotten stronger, and can "go back to doing basically anything I wanted to do."
Emory researchers have done safety tests of their angiogenesis procedure on 58 patients and say they are pleased with the results.
But scientists say the treatment is still in the early stages of development. One concern is that new blood vessels could grow in places where they are not wanted, like the eyes and kidneys.
A team at Tufts University in Boston used gene therapy on 16 male patients with severe blockages. Researchers told the AHA meeting Monday the men had less chest pain after the treatment and had to take fewer drugs.
The treatment involved injecting a gene that controls production of VEGF, or vascular endothelial growth factor, which instructs the body to grow new blood vessels.
The 16 volunteers, aged 53 to 71, all had suffered heart attacks. All had blocked arteries, and all had had either bypass surgery or angioplasty to stretch open their clogged blood vessels -- many of them several times.
Yet each time the blockages came back. Most of the men had such bad chest pain they could not live normal lives.
After having the VEGF injected into their hearts, all but one of the patients reported the reduction in chest pain was "marked," starting just 10 days after treatment.
Again, researchers stressed that more research is needed, but they said the potential for treatment is huge.
Dr. Jeffrey Isner said about 250,000 patients a year have ischemia, or blocked blood flow, for which bypass surgery, angioplasty or drugs have not worked.
"For these patients there is currently no other treatment option," he told a news conference.
Also at the AHA meeting Monday, University of Michigan surgeon Steven Bolling said surgical repair of a heart valve can greatly extend survival rates for patients with congestive heart failure, which claims about 250,000 lives each year in the United States.
Bolling developed the new procedure as an alternative for patients whose only other hope was a heart transplant.
It involves reconstruction of the mitral valve, which controls blood flow between the upper and lower chambers of the left ventricle, the heart's main pumping chamber.
Bolling has performed the operation 92 times in the past five years. He said one-year and two-year survival rates have been 80 percent and 70 percent, respectively. He said those rates would have been, at best, 20 percent without the surgery.
About 100 of the operations have been performed at other U.S. hospitals, said Bolling, who added he hoped they would become a standard treatment.
"I hope we can intervene and avert the inexorable march toward heart failure and death," he said.
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