Transcatheter cardiac valve replacement has already allowed thousands of otherwise ineligible people to receive a life saving replacement valve, but for particularly young patients delivering a valve is still a challenge since the vasculature is too small to support intravascular catheters. Now in a world’s first, a one year old in Belgium received a heart valve that was delivered to its destination transhepatically.
The patient already received a valve replacement in an open heart surgery shortly after birth, but because the infant’s hyperactive immune system destroyed the valve a year later, another surgery was required. The surgical team at University Hospitals Leuven decided to attempt a less invasive option this time to cause less trauma for the patient and proceeded to navigate the catheter through the liver and to the heart. Additionally, in order to correctly fit this tiny patient, the valve was manually trimmed and tested prior to the procedure to make sure it matched the anatomy.
Since making sure the liver is properly cauterized following the procedure was a critical component, the team had a liver surgery specialist on stand-by in addition to a pediatric cardiac surgeon in case resorting to open access was necessary. Thankfully the procedure went as planned and the patient is back home moving forward with begin a regular kid.