Ruber International Hospital performs a complex tricuspid valve replacement procedure

Ruber International Hospital has successfully completed a complex procedure to implant a biological tricuspid heart valve percutaneously . Located between the right atrium and ventricle, this valve is composed of three leaflets and its function is precisely to regulate unidirectional blood flow from the right atrium to the right ventricle.

The procedure, which lasted approximately one hour, was performed by doctors Luis Nombela, Pilar Jiménez-Quevedo, Eduardo Pozo, and Dr. Carlos Macaya himself , in addition to three foreign specialist technicians in charge of the technology used.

The patient, a 79-year-old man, underwent surgery eight years ago for a metallic aortic valve (made of artificial materials), "so he is anticoagulated," explains the physician, meaning he takes blood thinners to prevent blood clots. In 2002, due to a blockage, he was fitted with a pacemaker, the batteries of which were replaced in 2019. He currently had massive tricuspid insufficiency, which is the reason for the surgical procedure he has now undergone.

Specifically, Dr. Luis Nombela explains, the prosthesis has been placed on the leaflets of his tricuspid valve , "which have been held together with a kind of nine anchors and where the new tricuspid annulus has been fixed. Inside are the new three leaflets, which now open and close normally. These valves, which are subjected to greater wear on the left side of the heart due to the high pressures to which they are subjected when opening and closing with each heartbeat, last 10 to 15 years. Therefore, the specialist points out, "on the right side, where pressures are lower, and although these types of valves have been placed by catheter for less than five years, it is presumable that they will have the same or greater longevity."

Tricuspid valve dysfunction can lead to heart problems , including tricuspid insufficiency , which occurs when the valve doesn't close properly, or tricuspid stenosis, which narrows the valve. These dysfunctions cause blood to accumulate in the right atrium, venae cavae, liver congestion, and so on. This is known as right heart failure.

To perform the tricuspid valve replacement, the patient was given general anesthesia because the entire procedure is performed with a transesophageal ultrasound probe, whose images are crucial for the correct implantation of the prosthesis and which were monitored by cardiology imaging expert Dr. Eduardo Pozo . "That's why it would be very uncomfortable and uncomfortable for the patient without that anesthesia." Specifically, it is performed through the groin, via the femoral vein, so "it's not even necessary to cannulate the artery."

According to cardiologist Luis Nombela, "From the groin, where the team makes a small, two-point incision in the skin, we puncture the femoral vein. Its large size allows us to introduce and advance a catheter approximately one centimeter in diameter to the right heart, where the tricuspid valve is located."

Immediately after the surgery, the patient was transferred to an intermediate ward, "not even the ICU," Dr. Macaya emphasizes, regaining full consciousness about an hour later. "The recovery is very good," he states, adding that the patient remains under observation for two or three days. After that, if everything goes normally, the patient is discharged from the hospital and can lead a completely normal life, including exercising if he or she so desires.