See video here https://www.youtube.com/watch?v=o0fh_pX12jo
The team of the Cardiac Surgery Clinic, together with a guest surgeon from the Vienna University Hospital, has performed minimally invasive heart valve implantation. The purpose of this cooperation is introduction of a new generation of valves in the practice of the modern Cardiac Surgery Clinic at the largest medical institution in North-Eastern Bulgaria. TAVI (transcatheter aortic valve implantation) is a cutting-edge procedure in which a biological valve prosthesis is implanted through a catheter system.
The head of the Cardiac Surgery Clinic at UMHAT "St. Marina" – Varna Prof. Dr. Plamen Panayotov explained that through that procedure the patient's recovery was achieved much faster since the operation was significantly more sparing for him/her. "In the process of gaining more experience with these new valves, the intervention will be performed much faster. Unlike the standard valve, which is stitched through 12 to 15 sutures, here there are three guide sutures, and the valve itself is constructed in such a way that the implantation and placement in place takes no more than three minutes. Most of the time is spent clearing the calcium and removing the diseased valve tissue. Then the implantation is carried out very quickly. It is important that the valve itself has very good hemodynamic characteristics, that is, it does not create a gradient between the left ventricle of the heart and the aorta, and the heart functions under much better conditions," added Prof. Panayotov.
The equipment for minimally invasive surgery is provided by Medical University – Varna. This is extremely high tech equipment both as instrumentation and as a thoracoscopic apparatus. Based on the achieved clinical, scientific and academic results, the Cardiac Surgery Clinic at UMHAT "St. Marina" – Varna has established itself among the leading cardiac surgery centres in the country, along with the major world clinics.
An essential characteristic of this highly effective procedure is that the access to the patient's heart is made through a small opening of approximately 8 cm. Consequently, this is a prerequisite for much more favourable results for the patient in comparison to standard surgery.
"The procedure combines the advantages of surgery and TAVI (transcatheter aortic valve implantation)," emphasised the guest surgeon Prof. Günther Laufer, head of the Cardiac Surgery Department at University Hospital – Vienna. On the one hand, we have a valve that provides a long-term result – up to 20 years – this is the TAVI valve, and on the other hand, we have a stent that pushes everything aside through a completely new mechanism that provides absolutely good flow to the valve. What we know is that the pressure between the left valve and the main aorta vessel is very low, which is better for the patient both at rest and during activity," said Prof. Laufer.
Thanks to the tradition of sustainable partnerships with leading medical specialists in the field of surgery from all over the world, as well as the experienced team of specialists at UMHAT "St. Marina" – Varna, such minimally invasive implants will save human lives and give a chance to many patients in Bulgaria to continue performing their daily functions, even after suffering heart attacks.
Prof. Günther Laufer further explained that the valves were either biological or mechanical. "A biological valve is composed of biological tissue, which means that it may be a pig heart valve or a cow pericardium that is made according to the shape and size of the human heart valve. In the long term, there is no need to use medication to move the blood around in a biological valve. This is also its main advantage. However, it may change. On the other hand, the mechanical valve is composed of compressed carbon, and of course, it is not biological tissue. Therefore, blood-thinning medication throughout the patient's life is needed to prevent thrombosis or embolism due to the valve. These are the main differences. In addition, while using the mechanical valve it is possible some very light noise to be audible – coming from the heart, when the heart is opening and closing, while in biological valves there is no such noise. However, the mechanical valve is forever, and the biological valve can be regenerated," said Prof. Laufer.
When performing this operation, the choice of the type of a valve depends on the patient, however, specialists also give their recommendations. "We recommend mechanical valves up to the age of 60. Between the ages of 60 and 70, it is entirely up to the patient's decision, because he/she is going to live with the valve, and no one but the patient could say how he/she would feel best. And over 70, we would prefer a biological valve," Prof. Laufer added.
The highly effective procedure for minimally invasive valve implantation carried out with unique to the region equipment shows once again that the Varna University Hospital "Saint Marina" is a centre for innovation in the field of medical technologies, methods for combating socially significant diseases, university education and science, and effective treatment of patients. UMHAT "St. Marina" – Varna is a springboard for highly qualified medical professionals, some of whom continue their professional career, occupying management positions at other public and private medical institutions.
