Innovative technologies for minimally-invasive valve replacement implemented at Maria Middelares General Hospital

On Monday, 21 June 2021, two innovative techniques for minimally-invasive valve replacement were implemented by Dr Cornelis and Dr Floré at the Maria Middelares General Hospital Heart Centre. This provided additional options for a diseased aortic valve to be replaced by an artificial valve using a catheter (TAVI).

With the first technique, a new valve is placed in an old artificial groin via access to the groin. Given that the flaps of the old artificial valve are in the way of the coronary arteries, the team consisting of Dr Cornelis and Dr Floré adapted the ‘BASILICA’ technique guided by ultrasound. With a thing, electrical wire, the first old valve flap is cut off. Afterwards, the new valve prosthesis can be put safely in place. By using a hard balloon to widen the older valve ring (controlled ring fracture), the new prosthesis can work optimally.

The complete procedure is performed with only two small holes in the groin. As is usual in the Maria Middelares General Hospital Heart Centre, the brain is protected against stroke by using a filter system (Sentinel Cerebral Protection System).

With the second technique, a transaxillary valve replacement (TAVI) is performed. If there is severe calcification of the aorta and inguinal blood vessels, the aortic valve cannot be replaced in the classic way (via the breastbone or groin). Instead, the blood vessel in the left armpit is pricked to give access and the valve prosthesis may then be safely implanted.

Both procedures are minimally invasive, which means that patients will be able to leave the hospital sooner than usual. Our team of nurses and physicians are happy with this new step in the permanent evolution towards even less invasive valve replacements, even if it is technically so simple.