People in the east of England with a type of heart valve condition who were previously deemed too high risk for heart valve surgery or unsuitable for an existing procedure can now be treated thanks to an innovative device.
Royal Papworth Hospital NHS Foundation Trust, a specialist heart and lung hospital in Cambridge, has performed its first cases using an Edwards EVOQUE transcatheter valve replacement system to treat tricuspid valve regurgitation.
Tricuspid regurgitation occurs when the two flaps of the tricuspid valve do not close as tightly as they should. This allows blood to flow the wrong way, backwards, into the right atrium of the heart.
It can cause symptoms such as breathlessness and fatigue and, if left untreated, could cause heart failure because the heart is having to pump harder to get blood around the body.
Three patients have now been treated using the new device, a self-expanding dome which attaches to the tricuspid valve in nine places.
Tricuspid valve regurgitation (left) with blood flowing the wrong way; with the Edwards EVOQUE system in place (right). Credit: Edwards Lifesciences
Prior to its introduction at Royal Papworth Hospital, patients from the eastern region who had this condition could only be treated with much riskier open heart surgery or with a procedure called transcatheter edge-to-edge repair (TEER).
However, not everyone is suitable for these treatments.
“The tricuspid valve is made up of two leaflets, or flaps, that sit next to each other,” explained Dr Charis Costopoulos, Clinical Lead for Non-coronary Intervention.
“When these flaps do not close fully, it creates problems with blood flow. For a lot of patients, we can close this gap with the TEER procedure. But for patients who have a large gap, this is not suitable because the clips we insert cannot reach as far as they need to.
“And some patients are not suitable because they are too risky for open heart surgery, possible due to age or other conditions.
“Therefore, having this new system at Royal Papworth Hospital complements and further advances the transcatheter treatment options we can offer to our patients, allowing more patients to be treated.
“Like many other transcatheter treatments the procedure is minimally invasive, performed through the femoral vein in the leg, which allows for a shorter length of stay in hospital and quicker recovery, meaning we can treat more patients.
“I want to thank the entire clinical team, our structural valve nurse team, the catheter laboratory staff where this procedure is carried out, the ward teams where patients recover, the co-ordinators and all our referring hospitals across the region.”
The Royal Papworth Hospital team of consultants and specialist nurses with an EVOQUE valve device.