Focus on pioneering form of treatment of valvular heart defects
22.05.2014
The University Medical Center of Johannes Gutenberg University Mainz (JGU) has put in place Germany's first Professorship of Interventional Cardiac Valve Therapy. This professorship is based in the Department of Internal Medicine II (Cardiology, Angiolog, Poison Control Center) headed by Professor Thomas Münzel. The establishment of the new professorship underscores the position of the Mainz University Medical Center as one of Germany’s leading centers in the sector of this new discipline. Interventional heart valve therapy is a minimally invasive procedure that is used to correct heart valve defects. It is thus particularly non-aggressive as there is no need to open the ribcage as in the case of conventional cardiac valve operations in order to perform open heart surgery.
The two most common forms of heart valve defect can both be treated by means of interventional heart valve therapy. Interventional heart valve therapy, also known as transcatheter aortic valve implantation or TAVI, is primarily used to treat patients with stenosis of the aortic valve. This involves the insertion of a catheter, i.e., a tube some six millimeters in diameter, via the femoral artery into the heart. Cardiac surgeons then use the catheter to deliver a folded replacement valve. The diseased valve is not replaced in the process, but is covered by the new valve. Sometimes a balloon is inflated to help attach the new valve to the old, calcified valve.
The benefit of this form of keyhole surgery is that the characteristic side effects of standard open heart surgery, such as wound pain or delayed wound healing, are avoided with the result that patients tend to recover much more rapidly and experience fewer complications. There is also no need during a TAVI procedure to use a heart-lung machine as in the case of the usual surgical approach.
Although the technique is still new, TAVI was performed in almost as many cases as the conventional surgical procedure last year in Germany. Accompanying this development are promising initial results from the so-called PARTNER and PIVOTAL studies that demonstrate that the outcomes achieved using the TAVI method are better or at least equivalent to those observed following the use of conventional surgery in certain patients. The use of the TAVI catheter technique is predominantly indicated in patients for whom surgery represents an unacceptable risk because of their advanced age or because they have other concomitant complications.
Founded in 2010, the Interventional Heart Valve Therapy Unit is part of the Department of Internal Medicine II of the Mainz University Medical Center. "The MitraClip Registry shows that the unit has developed in recent years to become one of the main centers using the catheter technique to treat valvular heart disease and it is this achievement that we wished to emphasize by creating a Professorship for Interventional Heart Valve Therapy," said the Chairperson and Chief Medical Officer of the Mainz University Medical Center, Professor Babette Simon. More than 200 catheter valve replacement procedures are performed each year at the Mainz University Medical Center, making it one of the national reference centers for this technique.
In the view of Professor Ulrich Förstermann, the Chief Scientific Officer of the Mainz University Medical Center, the new interventional heart valve therapy strategy will give patients, particularly older patients in whom treatment was not previously an option, the chance to live longer, pain-free lives. "We hope to facilitate further progress in this promising field by making it one of our focal research areas here in Mainz," added Förstermann.