UI Heart and Vascular Center performs first-in-Iowa catheter-based tricuspid valve repair

catheter-based tricuspid value repair care team, photo

A University of Iowa Health Care team has successfully completed a first-ever heart valve procedure in Iowa: a minimally invasive tricuspid valve repair that involves a catheter instead of open-heart surgery.

UI Heart and Vascular Center specialists performed the operation on Oct. 18 at UI Hospitals & Clinics. The patient, a 77-year-old woman from Coralville, Iowa, was discharged from the hospital on Oct. 23.

The tricuspid valve—one of four valves that maintain regular blood flow through the heart’s four chambers—allows blood to flow from the heart’s right atrium to the right ventricle. When this valve is “leaky,” blood can flow back into the atrium, a condition known as tricuspid regurgitation. This can interfere with heart function, causing swelling, liver problems, fatigue, irregular heartbeat, and heart failure.

“Severe tricuspid regurgitation can be very difficult to manage with medications, and we have no approved treatments other than open-heart surgery,” says Phillip A. Horwitz, MD, an interventional cardiologist and director of UI Heart and Vascular Center. “In a patient who has failed medications and is too sick for surgery, we can adapt a catheter device designed for a different valve and use it to repair the tricuspid valve.”

Horwitz was a member of the tricuspid valve repair team, along with imaging cardiologist Ramzi El Accaoui, MD, cardiothoracic surgeons Mohammad Bashir, MBBS, Jay Bhama, MD, and nurse practitioner Lana Goldsmith, FNP.

For this new procedure, UI Heart and Vascular specialists used “clip” technology typically used to fix the heart’s mitral valve. It involves a tiny clip attached to a catheter, which is inserted into the patient’s thigh and guided to the heart. The clip is used to clamp the leaky part of the tricuspid valve, allowing the valve to immediately start to work normally.

For patients with tricuspid regurgitation who are not good candidates for open-heart surgery, the catheter-based, minimally invasive approach is a viable option. For these patients, the benefits include minimal pain, plus fewer pain medications, less trauma, and a faster recovery as compared to open-heart surgery. Although the procedure is not yet approved by the U.S. Food and Drug Administration, a few advanced centers are able to provide this groundbreaking technology to appropriate patients. 

“Managing patients with complex heart disease such as this requires a team approach,” says Bhama, one of the cardiothoracic surgeons on the team. “We bring together a wide range of experts to create an individualized treatment plan for each patient.”

Jan Wicks, the patient who underwent the new tricuspid valve repair on Oct. 18, says the procedure was “all that I could have hoped for.”

“The doctors and nurses did a great job explaining everything beforehand, and the procedure went well. I feel good,” Wicks says. “It’s great that I’m able to go home after only a few days in the hospital.”

The new tricuspid valve clip is the latest advancement in heart valve repair available at UI Heart and Vascular Center, according to Horwitz.

“This new approach speaks to our commitment to providing the most current and effective heart care treatments for our patients,” Horwitz says. “Our heart valve program, established a decade ago, involves surgical-medical teams and nursing staff with the advanced training to perform minimally invasive heart valve repair and replacement procedures. Working together as a team, we have the experience and expertise to deliver excellent outcomes for our patients.”

Learn more about the UI Heart and Vascular Center structural heart disease program and care team.

About UI Heart and Vascular Center

University of Iowa Heart and Vascular Center is home to more than 60 of the nation’s most experienced and highly trained cardiologists, cardiothoracic and vascular surgeons using state-of-the-art technology. Patients can access the latest heart and vascular treatment options and procedures via the main campus outpatient clinic in Iowa City, at the easy-to-access Iowa River Landing clinic in Coralville, or at one of the 12 outpatient clinics across eastern Iowa. New cardiology patients can be seen within 48 hours of requesting an appointment, ensuring the right treatment, at the right time, by the right specialists. University of Iowa Health Care is changing heart care and changing lives.