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A Better Way to Mend a Hole in the Heart

A Better Way to Mend a Hole in the Heart

Rush University Medical Center is the first hospital in Chicago to use a new technology that enables specially trained physicians to use a single stitch to close an opening between the upper chambers of the heart — a condition that is found in about one in four people, most of whom are unaware of it. Known as Noble Stitch, the new technology replaces the standard way to close this opening in the heart, which uses an implanted metal device that stays within the heart muscle.

“This new method eliminates the need for a patient to be placed on blood thinners as they do when a device is implanted in the heart,” said Dr. Clifford Kavinsky, professor of interventional cardiology and cardiovascular disease at Rush.

“Noble Stitch is considered a no footprint procedure, which means that it’s minimally invasive, using a catheter to place a stitch to close the hole and leaving nothing behind. Using the new method also reduces complications that can arise from an implanted metal device, such as the risk for blood clots or irregular heartbeats,” Kavinsky said.

This opening in the heart, also known as a patent foramen ovale, or PFO, remains when the upper heart chambers do not close naturally after a baby is born. The opening allows for blood to bypass the lungs in an unborn fetus until the lungs are exposed to air. After a newborn takes a first breath, the hole usually closes naturally within a few months.

“We have found that this opening remains in over 25% of adults. In the overwhelming majority of people it is a benign condition,” Kavinsky said.

Most people are not aware they have this opening. In some people, particularly the young, small blood clots can cross through this opening and go up to the brain and causes a stroke. In young people who have had a stroke because of this opening, there is a procedure where a catheter is inserted through a small incision in the inner thigh (groin) and then advanced up into the heart, where it is used to insert a device that stitches the opening closed,” said Kavinsky.

According to the American Heart Association, more than 1.3 million Americans have some form of congenital heart defect, with about 40,000 children born with a heart defect each year. The causes of congenital heart defects are unknown.

In January 2018, the FDA approved Noble Stitch for use in vascular and cardiovascular procedures in the United States.

“The NobleStitch EL, which has been used extensively in Europe and Italy, is an excellent option for patient with PFOs,” said Dr. Joshua Murphy, assistant professor of pediatric cardiology at Rush University Medical Center.

When done properly, the stitch provides the best short and long-term outcomes for patients, with essentially a natural, native, atrial tissue.”

“As a center of excellence for PFO treatment procedures, we are glad to be the first to offer this treatment option to our patients,” said Kavinsky.

A study for PFO closure using Noble Stitch will begin at Rush in the fall of 2019. To find out more about the procedure please call (312) 942-5020, or go to the Center for Adult Structural Heart Disease webpage.