At the Coimbra University Hospital Centre (CHUC) a percutaneous surgery on the tricuspid valve was carried out for the first time in Portugal in the Cardiovascular Intervention Unit (UNIC).
The tricuspid valve is located on the right side of the heart of all mammals and has the function of preventing the reflux of blood from the right ventricle to the right atrium of the heart. The valve's function is to allow blood to circulate between both parts of the right side of the heart. The valve opens and closes, allowing this movement to take place. If there is any abnormality in the valve, the blood will be regurgitated. Therefore, regurgitation causes less blood to be pumped from the heart to the body, which can result in heart failure, or cause the liver or legs to swell. Tricuspid regurgitation can be caused by lung diseases such as pulmonary hypertension or emphysema, or some type of disorder linked to the left side of the heart.
Diagnosis can be made using an electrocardiogram and symptoms are rarely present. However, a patient diagnosed with tricuspid regurgitation may experience pulsations in the neck due to high blood pressure in the right atrium, or even discomfort in the right side of the abdomen caused by the swelling of the liver.
A successful surgery
In more complicated cases, surgery is the most recurrent option to treat heart failure caused by regurgitation, as happened in Coimbra at the CHUC. According to Lino Gonçalves, director of the cardiology service at the hospital unit, "the treatment consisted of a minimally invasive intervention." In the press release, the professional added that the surgery was performed on a patient with symptomatic and severe tricuspid insufficiency. The surgery was carried out using the Pascal device, used for surgeries in the field of cardiology. During surgery, two clips were placed in the tricuspid valve and, according to Lino Gonçalves, "will allow the improvement of the patient's complaints of heart failure."
Despite having been performed for the first time, the responsible doctors were able to perform the surgery successfully and the patient went home the day after the operation.
Lino Gonçalves says that the fact that this intervention can be carried out in a less invasive way allows “the treatment of the sickest” with the disease. Mainly elderly patients, in advanced ages, for whom surgery can represent a high risk. Furthermore, it offers other patients in the same situation a valve treatment that was not performed until then and which can help in the “clinical stabilisation” of several patients.
The team responsible for the surgery at CHUC's UNIC consisted of Marco Costa, Luís Paiva, Ana Botelho and a team of doctors and technicians from the Hospital Clínic de Barcelona.