World's first minimally invasive replacement of the tricuspid valve at Mainz University Medical Center using newly approved technology

Prof. Dr. Philipp Lurz, Director of Cardiology, was already involved in the approval clinical study as European leader

11/13/2023

Last week, an artificial tricuspid valve was implanted for the first time worldwide at the Center for Cardiology at Mainz University Medical Center: With the Evoque tricuspid valve replacement system, the last of the four heart valves can now be replaced in a minimally invasive keyhole procedure without major surgery. The Director of the Center for Cardiology, Univ.-Prof. Dr. Philipp Lurz, is the European head of the approval study and carried out the procedure together with Univ.-Prof. Dr. Ralph Stephan von Bardeleben. The 62-year-old patient living in Mainz has recovered very well from the operation and is already feeling much better.

The tricuspid valve is one of the four heart valves and often becomes leaky in old age. This diesease leads to a series of symptoms that severely restrict the quality of life of the affected patients. These include severe fatigue, water retention in the legs and abdomen, shortness of breath, as well as changes in liver and kidney function. Surgery to treat the leak in the tricuspid valve is an option and is also performed gently on the beating heart at the Heart and Vascular Center of Mainz University Medical Center. However, patients often already have liver or kidney damage or significantly impaired right heart function, which significantly increases the risk of such an operation. 

In contrast, the field of minimally invasive treatment options for leaking tricuspid valves has developed rapidly over the last six years. A wide variety of procedures have been used, in particular the clip procedure for repairing the defective valve has already become part of everyday clinical practice. However, in the case of very complex valve anatomies, but also when patients come to the clinic too late, such a clip procedure can no longer be performed.

In this case, the valve must be completely replaced. "The Evoque system makes this possible for the first time without surgery via a catheter-based access through the vein. This allows us to virtually completely eliminate tricuspid valve insufficiency and give back a great deal of quality of life to many patients for whom there was previously no treatment option. This has been impressively demonstrated in the associated approval study," says Philipp Lurz, who performed the procedure last week together with Prof. Dr. Ralph Stephan von Bardeleben.

"Thanks to our expertise and the management of the pivotal study, we were in the unique position in Mainz of being able to perform the first procedure worldwide outside of trials. This procedure actually marks the point at which an innovation becomes reality," says Philipp Lurz happily. "This is precisely our mission at the Mainz University Medical Center: to drive innovation and make it a clinical reality."

Philipp Lurz is convinced that close cooperation between cardiologists and cardiac surgeons is essential and decisive for success: "The interdisciplinary work with Prof. Dr. Hendrik Treede, Director of the Department of Cardiovascular Surgery, who has great expertise in surgical heart valve therapy, is particularly noteworthy here and is also structurally anchored in the University Heart and Vascular Center founded some time ago."