The first percutaneous implantation of a new generation aortic valve was performed by doctors at the Upper Silesian Medical Center in Katowice-Ochojec. The valve can be folded and unfolded in the patient’s body, which makes it easier to place it in the optimal place.
The new generation of repositionable valves will now replace those used so far that left a very small margin of error. Even a small mistake could have big consequences. If it was placed even slightly inaccurately, the leakage around the valve would increase, and this study showed that this resulted in very unfavorable long-term results. Now, when it is possible to reposition an already inserted valve, any error can be easily corrected – told PAP the head of the Department of Invasive Cardiology at the Upper Silesian Medical Center, Prof. Andrzej Ochała.
The surgery was performed on a 72-year-old patient with severe stenosis of the aortic valve, which had been surgically replaced a few years earlier. For several years, the hospital in Ochojec has been at the forefront of Polish centers that perform transcatheter aortic valve implantation (TAVI), also in patients previously operated on by cardiac surgery. This method is an alternative for patients with multiple stresses, for whom subsequent surgical intervention is too risky.
The valve is inserted into the patient’s body via a catheter through an incision in the femoral artery. After implanting a new generation valve, we assess whether it is functioning well, whether it is in the correct position, whether blood is leaking around it. If all is well, detach it from the delivery system and complete the procedure. However, if we find that this position is not optimal, we can assemble the valve in the patient’s body, which takes several seconds and re-implant it in the correct place within a few minutes – explained Dr. Michał Lelek from the Department of Invasive Cardiology, who performed the first procedure.
This is a big improvement compared to the older valve type – the procedure is safer for the patient, more predictable and also simpler for the doctor, he added.
The procedures of percutaneous aortic valve implantation in patients suffering from its stenosis, who cannot be operated on due to multiple stresses, are a highly specialized procedure financed by the Ministry of Health. Valve stenosis is a heart defect that impedes the flow of blood from the left ventricle to the aorta, which, when severely severe, leads to heart failure and, if left untreated, can be fatal over several years. It occurs mainly in the elderly, after the age of 75.
Surgery is the primary treatment, but not all patients can be operated on because of too high a risk. Surgeons calculate the risk based on special scales. In the case of older patients with other diseases, it turns out that they might not survive the procedure. Once we could not offer them anything, now we have a new method of minimally invasive valve implantation – TAVi – emphasized prof. Oh, ooh.
Specialists agree that the demand for such treatments will increase as the society is aging and there will be more and more patients who do not qualify for surgery.
Aortic valve stenosis is the most common valve disease and the most common cause of valve surgery. The valve must withstand the large pressure difference between the left ventricle and the aorta. If we live longer – 80-90 years – it is more likely that the valve will degenerate, and past infections, kidney diseases, diabetes, and atherosclerosis may also contribute to it – explained Dr. Lelek.
A patient suffering from aortic stenosis has shortness of breath and decreased exercise tolerance. The patient we operated on had problems even with moving around the house, she could not function normally. If the stenosis continues over many years, left ventricular function is impaired in advanced forms and becomes progressively weaker. Fortunately, this unfavorable process can be reversed in many cases thanks to the valve implantation procedure, concluded Dr. Lelek. (PAP)