Heart surgery

Pioneering heart surgery in Portugal

For the first time a tricuspid valve surgery was performed in Portugal in Coimbra.

At the University Hospital of Coimbra (CHUC) percutaneous tricuspid valve surgery was performed for the first time in Portugal in the Cardiovascular Intervention Unit (UNIC).

The tricuspid valve is located on the right side of the heart of all mammals and has the function of preventing backflow of blood from the right ventricle to the right atrium of the heart. The function of the valve is to allow blood to flow between the two parts of the right side of the heart. The valve opens and closes, allowing this movement to take place. If there is an abnormality in the valve, the blood will be regurgitated. Therefore, regurgitation causes less blood to be pumped from the heart to the body, which can lead to heart failure or swelling of the liver or legs. Tricuspid regurgitation can be caused by lung diseases such as pulmonary hypertension or emphysema, or a certain type of disorder related to the left side of the heart.

The diagnosis can be made using an EKG machine and symptoms are rarely present. However, a patient diagnosed with tricuspid regurgitation may experience throbbing in the neck due to high blood pressure in the right atrium, or even discomfort on the right side of the abdomen caused by swelling of the liver.

A successful operation

In more complicated cases, surgery is the most common option to treat heart failure caused by regurgitation, as happened in Coimbra at the CHUC. According to Lino Gonçalves, director of the cardiology department of the hospital unit, “the treatment consisted of a minimally invasive intervention”. In the statement, the professional added that the surgery was performed on a patient with symptomatic and severe tricuspid insufficiency. The surgery was performed using the Pascal device, which is used for surgeries in the field of cardiology. During the surgery, two clips were placed in the tricuspid valve and, according to Lino Gonçalves, “will improve the patient’s complaints of heart failure”.

Although it was performed for the first time, the responsible doctors were able to perform the operation successfully and the patient returned home the day after the operation.

Lino Gonçalves specifies that the fact that this intervention can be carried out in a less invasive way allows “the treatment of the sickest” suffering from the disease. Mainly elderly patients, in advanced age, for whom surgery may represent a high risk. In addition, it offers other patients in the same situation a valvular treatment which was not carried out until now and which can help in the “clinical stabilization” of several patients.

The team responsible for the surgery at the UNIC of the CHUC consisted of Marco Costa, Luís Paiva, Ana Botelho and a team of doctors and technicians from the Hospital Clínic de Barcelona.