At London’s Royal Brompton and Harefield hospital, part of Guy’s and St Thomas’ NHS Foundation Trust, patients can benefit from novel minimally invasive procedures that can repair tricuspid valve regurgitation and avoid the need for open-heart surgery.
The new minimally invasive transcatheter approach targets treatment directly to where it is needed and offers significant improvements to quality of life in patients where surgery is not possible.
Tricuspid valve regurgitation consequences
Dr Robert Smith, a leading consultant interventional cardiologist based at Royal Brompton and Harefield hospitals explains, “Despite being historically overlooked, the tricuspid valve is crucial to heart health, and severe cases of tricuspid regurgitation are associated with significant mortality.”
It’s thought tricuspid regurgitation affects more than 70 million people worldwide and may be due to various factors including age and atrial fibrillation (AF).
At an early stage, symptoms can be mild; but, as the condition worsens, patients may experience breathlessness, fatigue and swelling of the ankles and legs and, rarely, the abdomen. While diuretic medication may alleviate some symptoms, only reparative surgery can properly restore valve function. As this involves open heart surgery, it’s usually only performed while the patient is having an operation for another heart condition.
Two types of low-risk non-surgical intervention
A minimally invasive non-surgical treatment is now being used and could be a game-changer for patients with tricuspid valve regurgitation, particularly those who are too high-risk for open-heart tricuspid valve repair because they are older, have additional health issues or have advanced heart failure.
The procedure is performed with a catheter which delivers direct treatment to the heart via a small incision in the groin. “There are two treatments available to patients,” explains Dr Smith.
“The first is transcatheter edge-to-edge repair (TEER) where a clip is used to reduce the leak. The second is transcatheter tricuspid valve replacement (TTVR), a newer procedure where the valve is replaced, and the leak is obliterated.” Both procedures are low-risk and take around two hours.
Tricuspid valve regurgitation procedure recovery
After a few days of monitoring, the patient is usually able to go home. “One of our patients – who was elderly, frail and possibly facing a palliative care pathway – had the TEER procedure and, a month later, was enjoying regular hobbies,” Dr Smith explains. “There’s no doubt it can make a real difference to people’s lives.”
- Find out more at guysandstthomasspecialistcare.co.uk
