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World Heart Day: conservative procedures on the heart are state of the art at the MedUni Vienna

Vienna (29th September 2011) – Open-heart surgery remains the general standard, however conservative procedures performed through the groin are becoming more and more common – and that includes at the Medical University of Vienna. For around six years, catheter-based operating techniques have been used at the MedUni Vienna for heart valve problems. The Department of Cardiology at the Vienna General Hospital, led by Gerald Maurer, also plays a key role in a number of studies aiming to further improve surgical techniques, and a new, interdisciplinary heart research centre aims to further highlight the MedUni Vienna’s leading position in the field of cardiovascular medicine.

“The risk of dying from severe narrowing of the aortic valve is as high as with advanced cancer”, says Maurer. Conservative procedures significantly alleviate the condition, often causing symptoms to disappear altogether. Another advantage is that patients only have to stay in hospital for a few days instead of the two to three weeks usual for open-heart surgery.

The most common conservative procedure is replacement of the aortic valve via catheter. The valve is implanted through the catheter, which is inserted into the femoral artery. In cases where the pelvic vessels are not suitable for this procedure, the same effect can be achieved with the minimally invasive method by puncturing the chest wall over the apex of the heart. Both types of intervention are carried out on an interdisciplinary basis through cooperation between the cardiology and cardiac surgery teams.

Maurer: “In total, we have around 50 patients per year on whom we use these methods. In recent years, the valve has improved dramatically, as has the catheter, which used to be more rigid and much more difficult to manoeuvre than it is nowadays.”

Mitral clip – extremely low-risk intervention
The second conservative method is the use of a mitral clip during a heart valve repair. The heart’s mitral valve stops the blood flowing back into the left ventricle. In patients with mitral valve regurgitation, this valve doesn’t perform very well. Shortness of breath, rapid exhaustion and cardiac arrhythmia are just some of the symptoms of this condition. In severe cases, surgery is unavoidable.

During the invasive procedure, a small clip measuring just a few millimetres is implanted. It closes the leaky mitral valve. Maurer: “This procedure is associated with a very, very low risk. If the clip does not achieve the desired effect in full, it can be undone straight away and the patient can undergo conventional surgery.” The method is still relatively new at the MedUni Vienna and has only been used so far in just over 20 cases. “Investigations are still ongoing into whether these valve procedures extend patient’s lives, however the initial results are promising. There is no doubt, however, that they improve the patients’ quality of life in the majority of cases”, says Maurer. “Their capabilities return and their shortness of breath disappears.”

New heart research centre at the MedUni
The MedUni Vienna is a world leader in the treatment of heart valve conditions. Many study results have been factored into the guidelines of the European and American heart research societies. Maurer: “The next step will be to find a preventative solution. There are a number of promising possibilities for this already.” Maurer continues: “And to further extend the Medical University’s leading position in cardiac research, we are in the process of planning a new heart research centre.”