Vienna (OTS) – Severe heart disease or pulmonary hypertension often leads to a leak in the tricuspid valve, the valve between the right atrium and the right ventricle. But tricuspid regurgitation can occur even without a clearly identifiable cause. So far, this leak has been treated primarily with medication using water-propelling agents and, for several years now, with clips in the heart valve. This meant that serious leaks could not be sufficiently remedied. With catheter-based valve replacement, a minimally invasive procedure is now available as a new treatment option for severe cases. At the University Clinic for Internal Medicine II of AKH Vienna and MedUni Vienna, the procedure was successfully carried out via the groin for the first time in Austria. It was the third implantation of this new heart valve worldwide.
If the heart valve between the right atrium and the right ventricle no longer closes, every time the right ventricle contracts, blood flows back into the right atrium. This pendulum flow in the right heart leads to heart enlargement and right heart failure. Shortness of breath, water retention in the stomach and legs and even kidney dysfunction are the consequences. Tricuspid insufficiency has so far mostly been treated therapeutically with water-propelling agents. Clip systems have been implanted for some time to treat the leak. In the so-called “edge-to-edge repair” procedure, two heart valve leaflets are connected to an implant. However, this procedure could not achieve sufficient results in patients affected by severe insufficiency. There is now a new therapy option for these with a new generation of heart valves. “In contrast to the clip system that has been in use for some time, the new tricuspid valve replacement involves completely replacing the heart valve. This means that even a severe leak that was previously difficult to treat can be treated minimally invasively via the groin,” says Philipp Bartko from the University Clinic for Internal Medicine II and head of the program for interventional therapy of structural heart diseases.
In December 2023, the complex procedure was successfully carried out for the first time in Austria by an interdisciplinary team with experts in cardiology, cardiac surgery, vascular surgery, radiology, anesthesia, nursing and technicians in the hybrid operating room at the AKH Vienna University Hospital. “With a valve opening area of 7 to 9 cm2, the tricuspid valve is very large. It has a diverse anatomy and can therefore also be insufficient in many different ways. The new heart valve implant adapts to the anatomy as it unfolds. This almost always completely eliminates the insufficiency. In order to carry out the procedure successfully, close interdisciplinary collaboration and, in particular, multimodal imaging are crucial. The collaboration with the University Clinic for Radiology and Nuclear Medicine creates a prerequisite for therapeutic success,” says Varius Dannenberg from the Clinical Department of Cardiology, University Clinic for Internal Medicine II of AKH Vienna and MedUni Vienna. In order to optimally prepare for the procedure, the interdisciplinary team trained the implantation on a three-dimensional phantom model before the procedure. This is the third time the implant has been inserted through the groin worldwide.
The catheter-supported form of therapy enables treatment to be gentle on patients and offers an additional treatment option for patients with complex heart valve diseases. “In the interdisciplinary heart team meetings at the University Hospital AKH Vienna, individual therapy strategies are developed in the spirit of personalized medicine in order to achieve the best possible results. We are pleased to be able to expand the therapy options with catheter-based tricuspid valve replacement,” says Christian Hengstenberg, Head of the Clinical Department of Cardiology, University Clinic for Internal Medicine II of AKH Vienna and MedUni Vienna.
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University Hospital AKH Vienna
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