Early heart valve surgery restores normal life expectancy

“The heart valves are essential for proper cardiac function. Once they are no longer able to seal properly, valvular insufficiency develops which overloads the heart and results in damage to it. This means it’s important that people go to the doctor for regular check-ups. The earlier that heart valve insufficiency is detected, the sooner it can be treated. Nowadays, surgical interventions to repair heart valves – such as the mitral valve – have good outcomes, with survival rates already in excess of 99.5%. If the mitral valve is repaired at an early enough stage, these days patients can expect to live as long as their age-group peers in the normal population,” explains Dr Patrick Perier, President of the European Association for Cardio-Thoracic Surgery (EACTS) and Senior Physician in the RHÖN-KLINIKUM Campus Bad Neustadt cardiac surgery team.

Gold standard – 40th anniversary of mitral valve repair

Each year, anywhere between 1,800 and 2,400 people require life-saving heart valve surgery in Austria alone. And the figure exceeds 36,000 in Germany. Mitral valve surgery is the second most commonly performed valvular surgery after aortic valve surgery. While the mitral valve could once only be replaced with a prosthesis, the first operation to repair one was conducted a good 40 years ago. Dr Patrick Perier was the first researcher to compare the long-term outcomes of mitral valve repair and mitral valve replacement. Since concluding his analysis, he has tirelessly advocated for the use of mitral valve repair as the gold standard for mitral valve surgery wherever possible. “The big advantage of mitral valve repair is that the valve continues to be actively opened by tendons, whereas a mitral valve prosthesis can only be opened passively by the blood flow. Repair also means that patients are no longer at risk of thrombosis and do not need to take blood-thinning medication. And the biggest advantage of all: patients have a significantly better survival rate ten years after undergoing mitral valve repair surgery than patients who were given a replacement valve. In fact, life expectancy is akin to that of the normal population,” Perier adds. Currently, 4,000 to 5,000 people per year undergo mitral valve surgery in Germany, and in 70-80% of cases, the mitral valve can be repaired. “My vision is to ensure mitral valve repairs account for as close to 100% of valve surgeries as possible in future,” Perier emphasizes.

Minimally invasive heart valve repair – small incision, greater effect

Since its introduction, mitral valve repair surgery has come on in leaps and bounds. “Whereas in the past the patient’s entire sternum had to be sawn open for the surgeon to obtain a good view of the site during the operation, today around 60% of cases involve a minimally invasive procedure,” Perier explains. Rather than looking at the mitral valve with the naked eye, the surgeons do so on a video monitor with the help of an endoscope. This delivers a number of patient benefits simultaneously: there is less of a physical burden placed on the body, less pain, less need for blood transfusion, a lower risk of complications, and shorter recovery times.

Mitral valve repair via blood vessels – a vision for the future

To make mitral valve repair even less invasive for patients in the future, research is currently ongoing into a procedure that will make it possible to repair the mitral valve purely through the vessels – i.e. without invasive surgery. “In the case of coronary heart disease, some work – such as implanting stents – is already widely conducted via the patient’s blood vessels. Although research into how to accomplish something similar with heart valve repairs is still at a very early stage, I believe this is where the future lies,” Perier concluded.

About cardiothoracic surgery and the EACTS congress

Responsible for 34.7% of fatalities in Austria, cardiovascular diseases are the country’s leading cause of death. Nowadays, congenital heart defects, coronary heart disease and heart valve defects can be treated using cardiothoracic surgery. The latest research and findings in cardiothoracic surgery will be presented at the EACTS Congress at the Austria Center Vienna between 4-7 October. https://www.eacts.org/annual-meeting/

About IAKW-AG

Internationales Amtssitz- und Konferenzzentrum Wien, Aktiengesellschaft (IAKW-AG) is responsible for maintaining the Vienna International Centre (VIC) and operating the Austria Center Vienna (ACV). The Austria Center Vienna is Austria’s largest conference centre. With 19 halls, 180 meeting rooms and some 26,000 square metres of exhibition space, it is one of the top players on the international conference circuit. www.acv.at