In these last few years, the surgical treatment of valvular heart disease has made remarkable progress, and it is now possible to avoid median sternotomy and dramatically reduce chest incision in many cases.

With the minimally invasive technique, the surgical treatment is executed via two incisions no more than 7 cm long, in the groin and right chest, respectively. The very good surgical outcome goes hand in hand with an excellent aesthetic result and a significant functional advantage, due to the fact that the rib cage remains intact, with no bone lesions.

The evolution of the minimally invasive surgery, where Istituto Cardiocentro Ticino boasts a decade-long experience, is paving the way for robotically-assisted surgical systems which will enrich in the future the technological endowment of Istituto Cardiocentro Ticino.

Nonetheless, heart valve surgery – though performed with state-of-the-art techniques – calls for the use of the heart-lung machine, and is thus not an option for patients with an uncertain clinical status, characterised by a number of concomitant diseases.

Cardiologists and cardiac surgeons are thus searching for new ways to make this surgical treatment compatible with high-risk patients. One of these paths is the so-called “transapical” technique, recently introduced at Istituto Cardiocentro Ticino with brilliant results. This technique involves the introduction, through the apex of the heart, of a biological prosthesis mounted on a catheter, which is then advanced up to the malfunctioning valve and expanded in the valve site, so that it overlaps with it, replacing it.

Thanks to this technique, aortic valve replacement takes place in an extremely short time and with no need to resort to extracorporeal circulation: the surgical “weight”, hence the risks involved, are dramatically reduced.