Cardiac surgeons at the University of Cincinnati have performed the first endoscopic 'triple valve' operation in the U.S.

University of Cincinnati performs first endoscopic 'triple valve' operation in the US

August 25, 2021
by John R. Fischer, Senior Reporter
UC Health cardiac surgeons in Ohio have performed the first-ever endoscopic “triple valve” surgery in the U.S.

Performed on 63-year-old Karyn Russell at UC Medical Center, the procedure bears its name from the replacement of the aortic and mitral valve and repairing of the tricuspid valve. The least invasive surgical procedure possible, it can help patients avoid open heart surgery as well as the risk of damage to bones.

Instead, surgeons simply make a small incision into the skin and operate on all three valves from there, according to UC Health cardiac surgeon Dr. Tommaso Hinna Danesi, who became an associate professor of surgery at the University of Cincinnati College of Medicine in Spring 2021 and performed the surgery on Russell.

"UC Health staff began training several months before my arrival. Once I knew I was coming to UC, I started to write a handbook about endoscopic cardiac surgery in which I gave tips and tricks for all the individuals involved in the OR, from the scrub nurse to the perfusionist to the surgical assistant and so on. The CTS staff worked hard, and in just a few months were able to perform this complex surgery," he told HCB News.

The sparing of the sternum and miniaturized incision site spares the patient the pain of open-heart surgery and results in a shorter hospital stay and faster recovery, according to Danesi. He says that endoscopic triple valve surgery reduces procedure time by 50% and results in fewer side effects, compared to open-heart surgery. Russell, for instance, was out of the hospital in less than a week following surgery and was cleared just one month later to travel to Chicago on a family trip and gorge herself on Chicago-style pizza.

Her quick discharge was because doctors did not have to cut into the bone and the risks were reduced because they did not have to stop the heart. To prepare for the operation, the surgeons worked with Dr. Frank Rybicki, UC Health vice chair of radiology and professor at the UC College of Medicine. Rybicki designed a state-of-the-art 3D map of Russell’s heart and valves. With it, Danesi and his team were able to prepare in advance.

"To my knowledge there is not a minimally invasive and endoscopic teaching program across the universities," said Danesi. "My hope and my wish are that endoscopic cardiac surgery may become the standard of care for patients suffering valvular disease and heart failure, because being gentle and less invasive with their body results in faster recovery and better quality of life."

Like the cardiac surgeons at UC Medical Center, surgeons at Duke University Hospital also made a first in July when they successfully implanted a new generation artificial heart in a 39-year-old man with heart failure in North America for the first time. Developed by CARMAT, the implant had been studied and approved for use in Europe and was implanted in the patient as part of an FDA-approved trial that is assessing if the artificial heart is a viable and lifesaving option before transplant.

“As we evaluate this device, we are both excited and hopeful that patients who otherwise have few to no options could have a lifeline,” said Dr. Carmelo Milano, a transplant surgeon and the principal investigator of the device study at Duke, in a statement at the time.

The endoscopic approach was previously used to repair single and double heart valves afflicted with an acquired disease over time, or part of a complex congenital heart defect.