Status: 09.08.2024 05:00 a.m.
The cardiology clinics of the University Hospital Schleswig-Holstein (UKSH) in Kiel and Lübeck are among the first ten facilities worldwide that can treat the last of the four heart valves without major surgery.
Each of us has four heart valves – one of them was previously known as “the forgotten valve”. It is called the tricuspid valve. Its job is to allow the oxygen-poor blood from the body to flow through into the right ventricle so that it can be pumped from there to the lungs. If the valve is leaky, blood flows back and those affected have severely life-limiting symptoms: exhaustion, water retention, shortness of breath or loss of appetite. Until now, only symptomatic treatment was possible, because an operation using a heart-lung machine is often too risky for the patient.
Older people are particularly affected
The need for suitable therapy is not only great for this reason: three to five percent of people over 75 have a severely leaky tricuspid valve. Like Hannelore Elhardt from Schleswig: “I always walked with a walker, couldn’t breathe, couldn’t get dressed. I felt bad,” says the 82-year-old.
The valve prosthesis is five centimeters large and looks like a chandelier.
Her only hope: a recently approved technology that would allow her to have a new tricuspid valve inserted through the groin using a catheter. Although the method is so new, she decides to go for it: “I said: either/or – before that I would have been able to fall asleep in the evening and not wake up in the morning.” When she was treated two months ago, she was one of the first patients in the world to receive one of the new tricuspid valves.
Heart valve replacement using keyhole surgery
The replacement heart valve is five to six centimeters in size and can be folded up small. The technology comes from Minneapolis in the USA – a valve costs a good 40,000 euros. Folded up small, it is stretched into a catheter that is less than eight millimeters in diameter. The catheter is guided through the groin to the heart, where the valve is then placed in the right place and unfolded again. This is called keyhole technology. If everything goes smoothly, the procedure only takes a good hour. Nothing more remains than a small scar on the groin.
“Impressive” and “stunning” – Dr. Felix Kreidel on the new technology
Dr. Felix Kreidel, head of the Structural Heart Diseases Division at the UKSH Kiel, treated Hannelore Elhardt and other patients at the UKSH: “It is impressive that we can implant a stent measuring at least five centimeters into the heart without opening the chest. This is an amazing development.”
Intervention is teamwork
Prof. Dr. Derk Frank, Director of the Clinic for Internal Medicine III at the Kiel Campus, adds: “The special thing about the procedure is that cardiology, cardiac surgery and anesthesia work very closely together – as a living heart team. This is the only way the procedure can work.” The sophisticated technology is used at both university heart centers in Kiel and Lübeck – they are among the first ten centers worldwide to successfully replace a tricuspid valve through the groin using keyhole technology.
Low-risk procedure
The risks of the procedure are manageable – thanks to comprehensive planning and differentiated imaging using X-rays and ultrasound images during the procedure. Ten to fifteen percent of patients still need a pacemaker after the procedure. Two months after the procedure, many things are different for Hannelore Elhardt. She can live independently again, she just has her shopping brought to her: “I’ve become a different person. I can do everything and I no longer have shortness of breath. If I can’t do it today, I’ll do it tomorrow. I don’t regret the operation.”
More information
The university hospitals of Schleswig-Holstein and Göttingen have developed a new treatment method. The first results of a study are promising. more
Schleswig-Holstein Magazine
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Schleswig-Holstein Magazine | 07.08.2024 | 19:30
