by Health Editor
The implantation of a new prosthesis for the treatment of mitral valve insufficiency via the transfemoral approach was completed in Milan
Mitral valve regurgitation can be treated non-invasively (ie without a surgical incision) via the transfemoral route. Proof of this is a minimally invasive surgery that allowed a new mitral valve prosthesis to be implanted percutaneously. An improvement in the patients’ cardiac function was immediately noted – explains Bernhard Reimers, head of Clinical, Interventional and UCC Cardiology at Humanitas – confirmed at the follow-up after three months. The study will continue with the aim of making this technique available to those people who, due to their heart conditions, cannot afford other types of interventions. The intervention, carried out by the Interventional Cardiology team of the Irccs Humanitas Clinical Institute of Rozzano with the participation not only of Reimers, but also of Antonio Colombo (senior consultant in Humanitas), Antonio Mangieri and Damiano Regazzoli (interventional cardiologists of Humanitas) saw the collaboration of an Israeli-American team in an international study involving Mayo Clinic and Ohio Health in the United States.
The mitral valve, where and what it is for
The heart valves (tricuspid, pulmonary, mitral and aorta) open and close in coordination with the heartbeat, thus ensuring the correct functioning of the heart. When they open they allow the passage of blood from the atria to the ventricles and from the ventricles to the pulmonary or systemic circulation; when they close they prevent the blood from flowing backwards. The mitral valve, in particular, located between the left atrium and the left ventricle of the heart and regulates the passage of oxygenated blood from the lungs. We speak of mitral insufficiency when there is a valve closure defect which causes part of the blood to flow back into the atrium instead of into the aorta and a problem that affects about 1.7% of the Italian population, especially the elderly.
Symptoms of mitral regurgitation
The main symptoms of a malfunctioning mitral valve are: dyspnea (shortness of breath), swelling and fatigue. The mitral valve can be repaired or replaced surgically, but minimally invasive techniques have been developed in high-risk patients that allow repair, if the valve has a non-complex anatomy, or replacement, if the valve is very compromised. However, valves that are currently available for percutaneous replacement require an incision at the apex of the heart. This procedure can involve risks, and the valve can create a dynamic obstruction to the blood leaving the heart, which is why about 70% of candidates for transapical valve implants are then evaluated as unsuitable – explains Antonio Mangieri, cardiologist Humanitas interventionist -. With the new percutaneous mitral prosthesis, on the other hand, the risk of ventricle obstruction is minimized and surgical and post-operative recovery times are reduced since the procedure is performed through an incision of only one centimeter at the height of the groin which allows the patient to mobilize earlier than a cut at the apex of the heart. The operation lasts about three hours, under general anesthesia, and the patient then remains in Intensive Care for 24 hours, awake, for monitoring. The discharge takes place after about three days and check-ups are scheduled 1, 3, 6 months after the operation.
Treatments for the heart increasingly tailored
The positive results of this new treatment were made possible thanks to the collaboration of different experiences and an increasingly tailor-made approach, calibrated on the specific needs of the patient. From the first evaluation of each patient to the implementation of each fundamental intervention, a multidisciplinary approach explains Lucia Torracca, Head of Cardiac Surgery at Humanitas -. This new technique will allow us to expand the therapeutic possibilities available to us, from classic surgery to minimally invasive surgery up to percutaneous surgery, to select, from time to time, the most appropriate one for each person’s needs. The results obtained during the interventions were published in JACC Cardiovascular Interventions and presented by Antonio Mangieri at EuroPCR, the international congress of interventional cardiology held in May in Paris. The approach to mitral insufficiency through the implantation of these new valves is part of a percutaneous treatment program for valvular heart disease in the hospital’s interventional cardiology – concludes Gianluigi Condorelli, director of the Humanitas Cardiovascular Department and professor at Humanitas University.
July 12, 2023 (change July 12, 2023 | 10:41)
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