(Vienna, 18 June 2025) For the first time in Austria, the interdisciplinary heart team at MedUni Vienna and University Hospital Vienna has succeeded in performing a minimally invasive total mitral valve replacement via the inguinal vein in two patients with severe mitral valve insufficiency. Just a few weeks after European approval, a new catheter-based method was used that opens up new therapeutic perspectives, particularly for high-risk patients.
In both cases, the initial medical situation was complex - including a patient with a congenital heart defect and several previous operations. Surgical intervention was not feasible in these situations. Access was purely transfemoral, i.e. via the groin. Both patients recovered quickly and were discharged a few days after the procedure in a stable condition with excellent results. "This method represents a milestone for patients with severe mitral valve insufficiency for whom established procedures no longer offer a solution. The minimally invasive strategy creates new opportunities for a particularly vulnerable group of patients," emphasizes Philipp Bartko from the Clinical Division of Cardiology at University Hospital Vienna and MedUni Vienna.
Daniel Zimpfer, Head of the University Department of Cardiac Surgery, emphasizes the interdisciplinary nature of the procedure: "Close collaboration between cardiology, cardiac surgery, anaesthesia, radiology and specialist care is crucial, especially for high-risk patients. The use of this innovative technology is an important step towards highly individualized care." The procedure was planned and carried out by an experienced team using state-of-the-art technologies. Iuliana Coti from of the University Department of Cardiac Surgery: "Catheter-based mitral valve implantation requires a deep understanding of cardiac anatomy and careful multidisciplinary planning. Thanks to the close collaboration of all the specialist areas involved, we can treat even anatomically complex cases safely and effectively."
Another breakthrough in interventional valve therapy
"The successful application of this technically challenging procedure demonstrates the high level of expertise in the field of structural heart medicine at University Hospital Vienna and MedUni Vienna. This makes Vienna one of the few international centers with experience in this method," emphasizes Christian Hengstenberg, Head of the Clinical Division of Cardiology. "With the catheter-based mitral valve replacement via the groin, the complete replacement of all four heart valves via a minimally invasive approach is now possible for the first time - a decisive advance that will have a lasting impact on modern cardiac medicine," says Philipp Bartko.
Background: What is mitral valve insufficiency?
The mitral valve separates the left atrium from the left ventricle and ensures the controlled flow of blood. In the event of mitral valve insufficiency, the valve no longer closes properly, causing blood to flow back into the left atrium and into the lungs. This results in shortness of breath, heart failure and long-term organ damage. For many patients, surgical replacement is not possible, for example in cases of advanced age, several previous operations or severe concomitant diseases. Repair procedures such as mitral valve clipping are often not sufficient for complex defects. Catheter-based replacement closes this therapeutic gap.
How the procedure works
Catheter-based mitral valve replacement is performed in two steps: First, a special "docking system" is anchored in the diseased valve. This serves as a stable base for the subsequent prosthesis. The new heart valve is then inserted transfemorally via a catheter and positioned precisely. Long-term data will show whether this technique establishes itself as a new standard therapy. It already represents a decisive expansion of the interventional spectrum at University Hospital Vienna and MedUni Vienna.