Dr. Vassilios Gulielmos
Ass. Professor for Cardiac Surgery
In the past decades there is a trend to reduce surgical trauma in cardiac surgery most times either avoiding median sternotomy or to stop the heart during surgery or even both.
Moving towards this trend we introduced transcatheter techniques for aortic valve insertion. This approach is addressed to patients with high morbidity not being amenable to conventional surgery. The biological valves used may not show such a long patency as those routinely used in standard cardiac surgery, but avoiding both median sternotomy and stopping the heart, this allows the performance of valve placement, even in multimorbide patients with excellent results.
Until now industry has only produced protheses for aortic valve procedures. Recently we had to treat an extremely sick patient of 78 years of age suffering from mitral valve stenosis after valve replacement several years ago. The valve was malfunctioning after so many years so a new one was necessary. The old patient with additionally lung and kidney diseases was at high risk for conventional surgery. Industry has not brought a model on the market for cases like that yet, so we were forced to place a valve for aortic procedure, inverted, due to the different location. The procedure was carried out within 25 minutes and was uneventful, as the postoperative course of the patient.
The patient left hospital after almost one week and is alive and doing well.
We look forward to soon receive the new valve for mitral procedure from the industry, to may help more heavily diseased patients not for science sake but for the wellbeing of our patients.