Treatment of diseased aortic valve through groin now even safer

Aortic valve stenosis is a common valvular disease. It causes the heart to have to work harder to pump the blood to the rest of the body through a narrowed aortic valve. In the long term, this may result in untreatable heart failure. In the past, the only treatment option available was surgical valve replacement. This involved opening the sternum and the use of a heart lung machine. In the last decade or so, new techniques have enabled surgeons to replace the valve with a bioprosthetic valve through a catheter that is inserted through the groin. Thanks to this technique, patients could be treated who were at too high a risk of difficult recovery after surgery. However, the method of insertion through the groin may also lead to complications. For instance, there are known risks of stroke, groin bleeding and a pacemaker placement operation may have to take place.

New filter system reduces risk of stroke
Continuing efforts are being made to reduce complications like these and to optimise the results of the operation through new techniques and the use of new materials. At the Maria Middelares Heart Centre, we always strive to offer these to the patient as early as possible. A new filter system that is placed in a vein in the neck during the procedure to keep the risk of stroke to a minimum has been used for the first time in Belgium. This system was first used in the Heart Centre in November 2018.

Other important developments increasing safety and comfort

• The Heart Clinic at our hospital conducted valve replacements through the groin for the first time in 2010. This was a milestone in the TAVI (Transcatheter Aortic Valve Implantation) programme of Maria Middelares General Hospital.

• Through the use of the latest bioprosthetic valves, results further improved and the risk of complications (e.g. the need for a pacemaker) decreased substantially.
• Evidence from clinical studies enabled further evolution in patient selection: from inoperable patients to lower surgical risk patients.
• By using the most recent delivery catheters, patients with narrower femoral arteries can also be treated safely and successfully.
• The improved techniques and increasing expertise now also allow for operations to be carried out under local anaesthetic, ensuring quicker recovery after the procedure.