CLINICAL INNOVATORS
Interview by
KATLYN NEMANI, MD
Pioneering Novel Treatment
for Heart Valve Disease
I
nternationally known for his expertise in novel
percutaneous and transcatheter approaches to
heart valve disease, D. Scott Lim, MD, currently serves as the medical director of the Advanced
Cardiac Valve Center at the University of Virginia.
He specializes both in the elderly and in children
with acquired and congenital heart valve disease.
Dr. Lim created and continues to run a humanitarian charity endeavor between UVA and Cedimat
Hospital in Santo Domingo, Dominican Republic,
for the care of patients with rheumatic heart valve
disease, as well as for the education of Dominican
physicians who care for them. Dr. Lim completed
his medical school training at Mayo Medical
School in Rochester, MN, his residency at Wright
State University, and his fellowship at the University of Michigan.
How did you become interested in heart valve
technology?
When I came to the University of Virginia 15 years
ago, the only established percutaneous therapy
for heart valve disease was balloon mitral commissurotomy for rheumatic mitral stenosis. I had
been trained to do that procedure, but prior to my
arrival, it wasn’t available in the commonwealth of
Virginia. While initially a niche therapy, I decided
to focus on helping patients with heart valve disease. I started our humanitarian collaborations in
developing countries to both maintain my experience with rheumatic heart valve disease therapies,
as well as to find ways to contribute–particularly to
impoverished patients without other avenues
available to them. As I continued in this, I discovered I really appreciated being able to provide
less invasive therapies to such patients. From there,
I got into the original randomized trials for both
TAVR (transcatheter aortic valve replacement) and
MitraClip, and have continued to help expand what
is available to patients with heart valve disease.
While initially a niche therapy, I decided
to focus on helping patients with heart
valve disease.
36 CardioSource WorldNews
Are most physicians aware of the minimally
invasive techniques available for repairing heart
valves? What are some of the barriers to access
to these procedures in patients who are not
candidates for traditional heart surgery?
Many physicians are aware of TAVR now, and
adoption of that less invasive therapy is spreading
rapidly. However, I think that many physicians
are not aware that we have ongoing clinical trial
endeavors on how to repair or replace the tricuspid, pulmonic, and mitral valves as well. I think
the first barrier to access for patients with heart
valve disease who are not good surgical candidates
is our knowledge base. We jumped into aortic
valve disease and had success in part because that
disease, and the therapy for it, is relatively binary.
For example, it is either severe or it’s not, and the
patient is either symptomatic or is not, and the
September 2016