The Queen’s Medical Center is poised to begin the state’s first heart valve replacements via catheter through the groin for heart disease patients previously deemed inoperable.

The new cardiac procedure for aortic stenosis, a severe narrowing of a heart valve, will make it possible for patients too ill to tolerate the standard valve replacement via open-heart surgery to receive treatment.

"We consider some patients inoperable, maybe too weak, too old or not strong enough to tolerate that kind of operation," said Jeffrey Lau, Queen’s chief of the department of cardiovascular diseases. "They had previous surgery or the risk is quite high because they have other medical problems. (The new surgical procedure is) considered less risky and more tolerable."

The procedure, which will be launched this year, is similar to minimally invasive heart surgery through the groin using stents to prop open arteries.

Queen’s is partnering with local cardiac surgeons and cardiologists to form the Pacific Valve Consortium, a group that will identify and treat patients.

A narrowing of one of four heart valves that connect the heart to the aorta typically occurs in the aged, who are sicker and have multiple conditions. More than 100,000 people in the United States live with aortic stenosis. A large number of them are considered high risk nonsurgical candidates because they are too fragile to survive open-heart procedures.

In Hawaii, there are between 400 and 500 patients per year with severe aortic stenosis who require valve replacements, which can now be inserted either via an artery in the groin or through the tip of the heart through a small incision between the ribs, according to Christian Spies, Queen’s medical director of cardiac invasive laboratories.

"If we do open-heart surgery we put the heart to rest for a short period to operate on the heart," Spies said. "For this (new) procedure the heart keeps beating on its own. With improving technology we are more and more able to fix heart problems without opening the chest at all."

The new procedure, known as transcatheter aortic valve replacement, received approval in November from the U.S. Food and Drug Administration after a series of clinical trials. Queen’s is the only Hawaii hospital approved to do the surgery.

Surgeons have routinely used minimally invasive procedures through the groin to insert stents to open arteries or to surgically close holes in the heart for the past 15 to 20 years.

"The last frontier is replacing an entire valve with catheters from the groin," Spies said. "We have an aging population where this becomes more of an issue."

The procedure is expected to reduce health costs since previously inoperable patients who can now have valve replacements are less likely to return to the hospital for related problems including heart failure, difficulty breathing and chest pains, he added.

The procedure has been approved at 100 to 150 select medical centers across the nation.