Carapetis J.R > et al (2015) Acute rheumatic fever and rheumatic heart disease
NATURE REVIEW Dis Primers
doi:10.1038/nrdp.2015.84
Rheumatic Heart Disease (RHD) is an under-appreciated deadly disease affecting at least 35 million people worldwide. This is a similar number when compared to HIV/AIDS. Yet RHD receives less than 1/200th of the research funding. In 2018, the WHO declared RHD as a global health priority. RHD is a preventable condition triggered by streptococcal bacteria. This bacterium is responsible for a common throat infection known as Strep Throat. When left untreated, a patient’s immune system can turn against their own heart while fighting the infection. This leads to an acute inflammation of the heart and the heart valves accompanied by Acute Rheumatic Fever.
It is often followed by chronic RHD that irreversibly damages the patient’s heart valves. Once patients become symptomatic, open heart surgery is currently the only treatment. In developing countries, this is not feasible from a medical infrastructure, medical skills or cost viewpoint.
RHD has largely been eliminated in Developed Economies of the world. However, other types of heart valve disease remain common. Mainly caused by age or lifestyle choices, degenerative valve diseases affect an increasing proportion of the population. Treatment levels vary by country, but remain low – in the single digit percentages.
While Heart Centers capable of open heart surgery are a scarcity in most regions with a high prevalence of RHD, the number of Regional Hospitals with good general surgical skills has been continually increasing over recent decades. The potential role of such hospitals in expanding cardiac care is widely accepted.
SAT solutions eliminate the requirement for open-heart surgery.
SAT’s heart valves are suited for younger RHD patients in whom conventional heart valve prostheses often degenerate rapidly
The most common heart valve disease in developed markets is called Aortic Stenosis (AS) – a condition where a hardening of the aortic valve is caused by calcium deposits. A second condition called Aortic Regurgitation (AR) is less common. In severe cases of both diseases, the historic method of valve replacement has been via invasive open-heart surgery. In 2007, regulatory approval was granted in Europe to perform valve replacements via a minimally-invasive tube/catheter (transcatheter aortic valve replacement or TAVR). This technology was adopted by other advanced economies over the next 5 years, and is now common to treat AS. The market-leading transcatheter aortic valve is moved into position in a crimped-down state and expanded by a micro-balloon when in place. Other valves use a self-expanding metal technology.
SAT’s TAVR is unique in that it is a second generation balloon expandable valve, designed to treat both AR and AS (in developed and emerging markets), with extended durability, at a significantly reduced cost.