Heart: tricuspid valve repaired without a scalpel. Innovative procedure performed at ISMETT.

Tricuspid valve repair with no scalpel, using a minimally invasive technique. The procedure took place at ISMETT and is one of the few of its kind ever performed in Italy.

A “torrential” (i.e., severe) tricuspid regurgitation was repaired through an inguinal vein using innovative transcatheter techniques and without opening the patient’s chest. The procedure was performed by ISMETT’s Interventional Cardiology team led by the chief of the unit, Dr. Caterina Gandolfo. The patient is well and has already been discharged.

From a technical point of view the procedure involves applying one or more miniaturized clips (TriClip™) that suture the flaps of the tricuspid valve together without having to open the heart. This procedure restores the normal closure of the valve at each heartbeat, thus reducing the degree of regurgitation, with considerable benefits for the patient.

Today, tricuspid heart valve diseases represent a major clinical issue and the last frontier of interventional cardiology.

The patient was a woman of approximately 80 years of age suffering torrential tricuspid regurgitation with severe clinical manifestations of cardiac decompensation and frequent hospitalizations. Open heart surgery presented high risks and was not taken into consideration because the patient suffered from severe COPD (Chronic Obstructive Pulmonary Disease), a lung disease that increases the surgical risk.”

“The procedure,” explained Dr. Gandolfo, “lasted about one hour and a half and enabled us to reduce the tricuspid regurgitation from a torrential to a mild degree: a more than satisfactory outcome. Our patient was able to return home after just two days of hospitalization. The TriClip implant doesn’t require a surgical incision. The device is delivered through the femoral vein with a small incision and only requires a general anesthesia to tolerate the transesophageal ultrasound performed to visualize the heart and guide the correct implantation of the clip.” ISMETT’s Interventional Cardiology Unit was one of the first in Italy to perform this innovative and complex procedure to correct tricuspid regurgitation. ISMETT’s Interventional Cardiology has extended experience treating valve diseases and has become a point of reference in Italy and in Europe for the non-surgical percutaneous treatment of cardiac valve diseases.

“For this outstanding result,” continued Dr. Gandolfo, “I wish to thank the director and the management of UPMC and ISMETT for their constant focus on innovation and quality.”

The causes of tricuspid regurgitation can be primary or secondary. Primary causes include an abnormal valve morphology caused by congenital defects, rheumatic diseases, trauma or infections; secondary causes include a functional form most frequently caused by diseases of the left sections of the heart or lung. Regardless of the etiology, tricuspid regurgitation is a disease that tends to worsen over time, as do the related symptoms, and associated with a poor quality of life.