Cardiology: Breakthrough in Tricuspid Valve Minimally Invasive Repair

A Macquarie University Hospital interventional cardiologist
has pioneered an innovative heart procedure that is helping patients avoid
heart failure and death. Macquarie University Hospital’s
Professor Martin Ng has successfully performed a minimally invasive repair of
the tricuspid valve to address tricuspid regurgitation, a condition where the
damaged valve leads to the backflow of blood from the right ventricle to the
right atrium.
Professor Ng successfully
conducted the procedure under the guidance of visiting German cardiologist
Professor Stephan von Bardeleben, Head of the Centre of Structural Heart
Disease Interventions and the Heart Valve Centre in Mainz, Germany. “This heart
condition is going untreated worldwide and the condition can be debilitating
and lead to heart failure and death,” Professor Ng says.
“Not only is there is a general
lack of understanding of this disease, but for elderly and high-risk patients,
the traditional open-heart method is too dangerous. “This minimally invasive
approach – rarely performed anywhere in the world – is beneficial for high-risk
patients for whom open heart surgery is too risky. With the general lack of
expertise, technology and understanding of this application, we are delighted
to have brought it to Australia for the first time.
“We are especially privileged
to have had Professor Bardeleben travel to Australia to oversee this first procedure.
He is the pioneer in the field and there is no better person to have had
alongside us as we performed our first case,” Professor Ng says. John Lakos is
the first patient in the Southern Hemisphere to undergo the tricuspid valve
repair. Since 1986, when John was diagnosed with aortic valve disease at the
age of 39, he has undergone several valve procedures – the first being a
procedure through open heart surgery to replace the faulty aortic valve with a
mechanical one. Earlier this year, his cardiologists noticed a leaky mitral
and severely leaky tricuspid valve.
“I felt breathless and found it hard to even climb a flight
of stairs,” Mr Lakos says. “Surgeons were reluctant to operate with open heart because
I had had so many open-heart procedures already. “The conventional solution was
for Professor Ng to perform percutaneous MitraClipping of the mitral valve with
the objective of releasing pressure on the tricuspid valve. If that didn’t
work, then we had no choice but open-heart surgery to implant an artificial
tricuspid valve. The hope was that the repair of the mitral valve would improve
the functioning of the severely leaking tricuspid valve.
“However, when I saw Professor
Ng to organise the proposed MitraClip, he presented me with an unexpected option.
A world-leading German cardiologist was coming to Australia to supervise a
tricuspid clip – never before performed in the Southern Hemisphere. Professor
Ng also advised that I had been selected because I was a suitable candidate for
the procedure. Accordingly, I became the first patient in the Southern
Hemisphere to undergo this procedure,” Mr Lakos says.
Professor Ng said that John’s
condition has dramatically improved. He no longer gets short of breath
conducting his daily activities and he has returned to his regular swimming
routine, something he has done for years as daily exercise. Macquarie University Hospital
has been a pioneer in keyhole cardiology surgery. It is a leading centre in
Australia for TAVI, performing a high volume of this game-changing surgery and
obtaining patient outcomes in line with international registries.
“Macquarie University Hospital
is not just performing well-established procedures,” says Professor Ng, who is
one of Australia’s leading interventional cardiologists. “We pride ourselves on trying what hasn’t been done before
and this latest surgery is an example.”
Source: Macquarie University
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