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Published by Hervé Wiard on February 16, 2024

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source “la-dépêche de midi”

In cardiology, the Pasteur clinic innovates to repair the “forgotten” valve
A new bioprosthesis makes it possible to repair tricuspid valve insufficiency, a heart disease in the elderly. Toulouse cardiology remains at the top. At the beginning of January, the Pasteur clinic was the first in France to implant a new device to replace the tricuspid valve percutaneously, without going through open heart surgery. An innovation that the clinic's cardiology teams have been working on since 2021. The tricuspid valve is one of the four valves that make up the heart, it separates the right atrium and the right ventricle. “We call it the forgotten valve. It has been the subject of less research and treatment than the others, probably because it is considered that the disease which affects it has less serious consequences,” says Dr Nicolas Dumonteil, cardiologist at the Pasteur clinic. “Fix the leak” When it malfunctions, the tricuspid valve no longer closes properly, creating dilation
less effective in the right part of the heart. “It is a disease that occurs in the elderly and, most often secondarily, in patients who have previously had problems with the valves on the left side of the heart. It then manifests itself as heart failure,” adds the doctor. To repair this “leak” which impacts patients’ quality of life, surgical intervention is necessary. Open heart surgery, the standard treatment,
cannot be offered to the most fragile, to patients for whom it would carry too much risk. The installation of “clips” which act like staples is not possible for all anatomy. This is where new devices such as EVOQUE ™ technology come in, a bioprosthesis implanted via the femoral route, the size of the tip of a little finger which unfolds like an umbrella and acts as a suction cup to seal the leak in the valve tricuspid. From 2021, the Pasteur clinic
participated in the clinical trials of this valve, a dozen were installed. The first patient came from Nançy On January 17, 2024, the Pasteur clinic was the first in France to implant the EVOQUE™ valve in its marketed version (CE marking obtained at the end of December 2023). A 46-year-old patient, who had had a heart transplant since the age of 15, referred by the Lorraine Heart and Vessel Institute in Nancy and the Henri Mondor University Hospital Center in Créteil, was able to benefit from it. In his case, traditional surgery was too risky and wearing a pacemaker did not make repair possible using a clip system. She returned home to Nancy and will now be followed in the traditional way, by ultrasound. “We have one more solution in our healthcare offering. We can respond to a need that was until now only covered within the framework of time-limited clinical studies,” concludes Dr Nicolas Dumonteil. Emmanuelle Rey
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