Some patients develop problems with the function of the valves of their heart.   This can either be due to a valve not opening or closing properly.   It is very common for the valve at the top of the heart, the aortic valve, to become stiff as people age.   The aortic valve fits atop the major pumping chamber of the heart.   When the heart muscle squeezes, the blood is forced through the aortic valve out to the entire body.  This valve can develop deposits of calcium and scar tissue over the years.   This can limit the valve’s ability to open properly.  This can eventually reach a point where the valve opening is very small.   No matter how hard or how fast the heart squeezes, only so much blood can go through that tiny opening.   This can cause problems such as heart failure, chest pain, lightheadedness and loss of consciousness.   Cardiologists refer to this problem as aortic stenosis.

The standard treatment for aortic valve narrowing, or aortic valve stenosis, has been surgical replacement of the valve.  There are different types of valves that can be used to replace the native valve.  This includes mechanical valves, valves made from animal tissue and human valves.  The problem with surgery is that it does require general anesthesia and opening the chest.   Surgery poses some potential risks and complications.   There is, of course, some discomfort involved with undergoing this procedure.  Patients must also allow some time for full functional recovery, usually 6 to 8 weeks.  Fortunately, over the years, surgery has become safer and more effective.  The expected risk of dying from a complication related to valve surgery for an ideal candidate is less than 4%.   The mortality rate associated with aortic valve surgery does increase substantially with increasing age, a weak heart muscle and other comorbid conditions.   These factors result in many patients not being even referred for the consideration of surgery.  The risk of the surgery might outweigh the potential benefits in this patient group.

There is a new technique for treating patients with aortic valve stenosis that is being studied in clinical trials.  This is actually using a catheter to position a new valve in the aortic position.  The valve is then placed utilizing balloon expansion.   The approach is similar to that used in cardiac catheterization and angioplasty.  There are different types of techniques for doing this new procedure and different types of valves being studied.   It is hoped that with more experience this type of treatment may ultimately offer lifesaving treatments for patients with aortic stenosis felt to be too high risk to undergo standard surgery.

The catheter based treatment of aortic stenosis is now undergoing clinical evaluations.  This is certainly not the standard of care at present and it is not likely ever to completely replace open heart surgery for the routine treatment of aortic stenosis.  It is hoped that this new technique may offer hope for patients not felt to be good candidates for conventional surgery.  Cardiology Physicians is closely monitoring developments in this area and will keep our patients informed.

Cardiology Physicians, P.A.
www.cardiocppa.com

Abby Medical Center
One Centurian Drive, Suite 200
Newark, DE 19713
302.366.8600

Foulkstone Plaza
1401 Foulk Road, Suite 201
Wilmington, DE 19803
302.478.5055

Meet the Physicians of Cardiology Physicians P.A.

JOHN J. KELLY III, M.D., F.A.C.C.
Dr. Kelly has been a member of Cardiology Physicians since 1996.  Dr. Kelly grew up nearby the Wilmington area in Delaware County, Pennsylvania.  He attended Garnet Valley High School.  His family belonged to the Graylyn Crest Swim Club in Northern Wilmington.  Dr. Kelly obtained a Bachelor of  Arts from Swarthmore College and attended Jefferson Medical College.  His post graduate training began with a residency in Internal Medicine at the University of Illinois in Chicago.  He served as Chief Medical Resident there.  His Cardiology Fellowship was at the Texas Heart Institute in Houston Texas.  Dr. Kelly’s recognitions include AOA membership, being named Intern of the Year at University of Illinois and being named Chief Cardiology Fellow at the Texas Heart Institute.  He was an Attending Physician at the Christ Hospital in Cincinnati.  He received a Teaching Award from the residents at Christ Hospital.  He was then an attending physician at Paoli Memorial Hospital and Bryn Mawr Hospital in Pennsylvania before joining Cardiology Physicians in 1996.  Dr. Kelly is a fellow of the American College of Cardiology and is board certified both in Internal Medicine in the subspecialty of cardiovascular disease.  He has additional board certification in interventional cardiology.

Dr. Kelly has a strong commitment to consultative cardiology and has been in practice since 1991.  Dr. Kelly has additional areas of interest including echocardiography, transesophageal echocardiography, stress echocardiography, diagnostic catheterization and catheter based treatment of heart disease.  He also has an interest in the treatment of peripheral vascular disease.  Dr. Kelly is the Medical Director for Cardiology Education at Christiana Care Hospital.

Dr. Kelly and his wife Janice were married in 1989.  Dr. Kelly and Janice are the proud parents of Jay and Brooke.  Dr. Kelly’s free time is spent enjoying family activities.  He spends as much time as possible on the sidelines watching his children compete in various athletic contests.  He enjoys chipping in with coaching when able.  He tries, without much success, to play golf.