Valvular Heart Disease Program There are multiple aspects of valvular heart disease that are well suited for our program developing an important referral-based practice. Furthermore, valvular heart disease is starting to undergo a major transformation from new percutaneous therapies. Several faculty are well published in aspects of valve disease and are developing important clinical and academic activities. Dave Fullerton, Chief of Cardiac Surgery, is skilled at mitral valve repair and the often-related need for atrial ablation surgery (Maze). Marketing of these services has begun with a mailing from Drs. Fullerton/Carroll to cardiologists and internist in the region. Ernesto Salcedo, Director of Echocardiography has an extensive experience in echo/Doppler characterization of valvular heart disease. The recruitment of Joseph Kay provides an adult-pediatric trained cardiologist to help develop the valve program. There are four interventional valvular heart disease therapies either established or emerging and we are investing considerable efforts to establish a regionally strong percutaneous valve program including: - Balloon therapy for stenotic lesions. John Carroll performs 20-30 procedures per year for mainly mitral but also aortic and pulmonic stenosis. The mitral balloon valvotomy program is the only one in the region and has resulted in numerous clinical research projects and publications especially with the use off intracardiac ultrasound. With the growing adult congenital program additional congenital aortic stenosis patients are coming for balloon therapy. - Percutaneous treatment of mitral regurgitation using a clip or suture techniques similar to the surgical Alfieri technique are now in clinical trials. With Rob Quaife’s expert TEE skills to guide the placement of a clip to the mid portion of the anterior and posterior mitral valve leaflets, John Carroll will be the local PI for a Phase 2 randomized trial (Everest 2) comparing this percutaneous approach to traditional surgery for Grade 3-4 mitral regurgitation. The company, eValve, has completed a Phase 1 trial showing safety and early efficacy. - Another percutaneous treatment of mitral regurgitation utilizes a cinching device placed in the great cardiac vein and producing a variation of an annuloplasty. James Chen, PhD has done important preclinical work using his 3-D technology. UCH may be a site for this clinical trial. - Percutaneous valve replacement. Several Phase 1 clinical trials will emerge for both the aortic and pulmonic valves and we expect to participate in one or more trials. Staff Listing: John Carroll, MD Director, PFO Closure Program Professor of Medicine John Messenger, MD Associate Professor of Medicine Ivan Casserly,MD Assistant Professor of Medicine Nurse Coordinators: Jana Keller, MSN Nurse Practioner