All news 28.04.2015

Three City Clinic Patients Underwent Bloodless Heart Aortic Valve Replacement


The state-of-the-art hospital is yet the second facility in Bulgaria where patients may undergo non-surgical (transcatheter) aortic valve implantation (TAVI)

Three patients of City Clinic were given the chance to return to normal life after undergoing the latest contemporary non-surgical (a.k.a. endovascular) treatment of the heart aortic valve in cases of severe aortic stenosis. Thus, the leading medical facility in the field of cardiovascular diseases became yet the second center in Bulgaria where patients of high-risk of open heart surgeries can receive vital treatment in a bloodless way.

The very procedure of endovascular (or transcatheter) aortic valve replacement – a.k.a. TAVI – is a bloodless intervention using a minimally invasive access through the thigh artery in order for a catheter to reach the heart and later deliver and place the valve prosthesis. The patient is not intubated, general anesthesia is not required; this is a very advanced and extremely friendly approach to the patient.

A several millimeter incision is made on the thigh and the valve is taken to the heart through the catheter where it unfolds and replaces the damaged valve. This is a revolutionary technology – the valve has been designed in a way to be able to reach the proper site of the heart through the fine catheter. Patients indicated for such an intervention are most commonly those aged over 75, people suffering pulmonary or renal pathology, patients with heart failure or benign cancer.

This non-surgical intervention offers huge advantages to all patients since it significantly reduced the procedure risk in comparison to the implemented so far open heart surgery, together with stopping the work of the heart and using a heart-lung machine.

This bloodless procedure is incomparably patient-friendly and people quickly resume their daily life routines; the risk of wound infection is reduced to minimum in comparison to the open surgery. Such a highly specialized and complex procedure requires the medical facility to have a trained team of invasive cardiologists, cardiac surgeons and anesthesiologists who work as a team in order to perform the endovascular implantation of heart valves.

To present day, a total of 6 patients underwent endovascular replacement of aortic valves and there are logistics preparation going on for the next group of suitable patients whose names and case history files will be sent to the National Health Insurance Fund for approval and financing. In Bulgaria, on an annual basis some 100+ patients are indicated to undergo this procedure since they unfortunately cannot undergo the alternative treatment of an open cardiac surgery.

Using this procedure of bloodless (endovascular) implantation of aortic valve, there are much wider opportunities for non-surgical treatment of serious heart diseases such as the valvular defects, and it opens the door to the development of further set of nonsurgical treatment techniques.