Last week in the rock'n'roll world, Mick Jagger, the Rolling Stones' lead singer, was about to undergo heart surgery. At 75, the prince of Rock cancelled the cult band's tour to the amazement of all the fans. "The operation was a success! "said the singer's entourage on Friday April 5th. Phew! The operation to replace one of his heart valves was a success. What we didn't know is that this operation uses a technology invented by a Frenchman and that since then it has saved hundreds of thousands of lives. Meeting with his discreet inventor.
Un "revolution": used to refer to the music of the Rolling Stones in their early days, the term also applies to the cardiac intervention technique from which Mick Jagger likely benefited. It was invented in 2002 by a Frenchman. « I'm not particularly a Rolling Stones fan, but it's a pleasure ", Professor Alain Cribier told AFP. « What's moving is the benefit that patients derive from it ".
Light surgery
With his soft voice and polished expression, this cardiologist is no rock star. All things considered, he's a rock star in his field. Professor Cribier is responsible for a major upheaval in the treatment of aortic stenosis. This condition, common in people over 65, affects one of the four valves of the heart, the aortic valve. Over time, calcifications may settle on this small valve, making it difficult to open and requiring replacement.
Traditionally, surgery is used, with a major operation: the chest must be opened, the heart stopped and blood flow diverted. The technique invented by Prof. Cribier is much lighter: generally performed under local anaesthesia, after a simple incision in the groin fold, a catheter is inserted into the femoral artery, at the end of which a stent...a sort of wire cylinder. It contains the artificial valve and a small balloon. The stent opens and the new valve expands by crushing the old one.
" It's revolutionized the way these patients are treated... "Dr. Stéphane Cade, a cardiologist in Montpellier, told AFP.
Designated by its English acronyms, TAVR or TAVI, this act allows the patient to resume his activities quickly, in just a few days. A delay that is unthinkable in the case of major surgery.
Mick Jagger, 75, was treated this way in a New York hospital, according to the specialized site Billboard. The singer confirmed on Friday that he has been treated and is feeling "much better".
Tears in the eye
The world premiere was made in 2002 in Rouen by Prof. Cribier, who then trained doctors all over the world. The practice of TAVI took off in 2009-2010. Since then, " 400,000 patients in 65 countries "have benefited from it," says its inventor.
Professor Alain Cribier
Initially, this technique was reserved for inoperable patients, particularly because of their advanced age. In recent years, however, other younger, so-called "intermediate-risk" patients have had access to it, after a 2015 study proved its usefulness for them as well.
And the number of patients targeted could soon explode. A new study, published In the mid-March issue of the New England Journal of Medicine, it was shown that TAVI can advantageously replace surgery even on patients with no particular risk. « I got a tear in my eye... ", confessed Prof. Cribier.
They used to let people over 75 die...
The idea came to him in the '80s. « At the time, they let people over 75 die, and they didn't operate... ", he says. After the failure of a first technique, finding a solution becomes "almost obsessive" for him.
" It felt like a bomb. No one thought it was possible to replace a valve without opening the chest... ", he recalls.
Yet the beginnings are not smooth: " The cardiac surgeons were completely against it, it was bloody, they were thinking: Who is this crazy guy who wants to take our job? ".
TAVI is performed by interventional cardiologists, not surgeons. Since then, " they were put in front of the evidence " and, in the face of the expected explosion, " a lot of people are going to start ", predicts Alain Cribier.
However, one unknown factor remains: the lifetime of the specific valves used for TAVI, made from bovine tissue and regularly improved. « We're a bit short on hindsight, since it's only a few years... ", notes Professor Hervé Douard, a cardiologist in Bordeaux.
No doubt that after this operation and a brand new rocker's heart, Jagger will be back on stage soon, unalterable, like a rolling stone.
Source: AFP
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