Up to half of patients with severe symptomatic mitral valve regurgitation are not referred for surgery because of the risks of the procedure. For them, an innovative tricuspid valve made from porcine pericardium may be a chance for treatment. - This is a chance of life for this group of patients, the last type of treatment that can be offered to them," says Professor Mariusz Kuśmierczyk, head of the Department of Heart, Thoracic and Transplant Surgery at the University Clinical Center of Warsaw Medical University. Unfortunately, the product is currently not covered by reimbursement.
Opportunity for seriously ill patients with mitral valve regurgitation
Published June 3, 2024 08:59
fot. iStock
Mitral regurgitation (MR) is the most common form of mitral valve disease. MR can be primary or secondary, and the preferred treatment strategy varies depending on the etiology. The prevalence of MR in the general population is about 2 percent. Clinically significant MR (moderate or greater severity) occurs in less than 1 percent of people under the age of 50, but already in more than 10 percent of people over the age of 70.
MR is often associated with heart failure (secondary MR), which is the first isolated cause of death in Poland, with 1.2 million people suffering from it - these statistics apply only to those diagnosed and the hospitalization of patients with heart failure consumed 90 percent of the budget allocated to treating the condition. Up to 50 percent of patients with severe symptomatic MR are not referred for surgery due to the risks of the procedure in elderly patients with multiple comorbidities. A therapeutic opportunity for such severely ill patients is the cutting-edge Tendyne valve, which opens up new treatment options for patients with severe MR who, due to their condition, have very limited therapeutic pathways.
The Tendyne™ Mitral Valve System is a transcatheter transapical bioprosthesis implantation system designed to treat native mitral valve defects. A three-lobed porcine pericardial valve is attached to a double stent made of nitinol, and connects via a cable to a plate that allows the device to be anchored in the apical region of the heart. The valve can be moved in and out intraoperatively to its full extent, allowing for proper positioning. The technology is available in several sizes to accommodate the individual, anatomical dimensions of the patient's heart. For a comment on the availability of the Tendyne valve in Poland as well as the effectiveness of treatment with this method, we asked Prof. Mariusz Kuśmierczyk, MD:
It's an option for patients who are ineligible for any other mitral valve procedures - either surgical or percutaneous - due to multiple burdens or anatomical conditions. This valve is one that is inserted through the apex of the heart, without the inclusion of extracorporeal circulation, from a small intercostal incision. This minimizes the risk of surgery. The procedure is performed under echocardiography guidance. This is a chance of life for this group of patients, the last type of treatment that can be offered to them. Unfortunately, the availability of this solution is not available in Poland for now. It is a non-reimbursed product at the moment; we are trying to get reimbursement.
