Samuele is 32 years old and has already had three heart operations: this is the story of a young patient who has been dealing with heart muscle problems since the age of 10. Samuele was operated on by the cardiac surgery team of Maria Pia Hospital, part of GVM Care & Research, for an aortic valve replacement surgery for the third time in his life.

“Due to a congenital problem we used a biological valve instead of a mechanical valve, which would last for life but requires daily anticoagulant therapy – explains Dr. Mauro Del Giglio, co-head of the Cardiac Surgery Department at Maria Pia Hospital – The biological valves need to be replaced after several years due to natural wear, but the previously implanted valve had only lasted 6 years due to sudden valve insufficiency. We had the opportunity to intervene by implanting a new latest generation biological valve with a minimally invasive method with duration expectations never seen before”.

The intervention therefore allowed the replacement of the damaged valve with a new and innovative one with the desired duration of over 20 years (studies attest the duration of the previous model to 17 years). The degree of complexity of the operation is also due to having set the basis for being able to intervene in the future, when – precisely, hopefully in twenty years – a further replacement will be necessary, via TAVI (Transcatheter Aortic Valve Implantation), or a transcatheter aortic valve implant which allows the new valve to be inserted passing through the femoral artery by placing it inside the previous one, without having to open the sternum and without total anesthesia. A new replacement therefore, but with a minimally invasive technique, as recommended by GISE (Italian Society of Cardiology).

Another peculiarity of this intervention was the adoption of a particular anesthesiological protocol: “At Maria Pia Hospital we pay close attention to the development of anesthesiological protocols with minimal impact on the patient – explains Dr. Del Giglio -. This is thanks to the synergy of different skills that flow into the Heart Team, a team of heart professionals in all its peculiarities and for all treatment phases. In particular, as regards anesthesia, we are adopting methods that do not require the use of opioids and which also allow the patient to wake up immediately without leaving the memory of intubation”.

At the age of 10, the patient was struck by rheumatic endocarditis which led him shortly after to the first replacement of the aortic valve. After about ten years the doctors had to intervene again, due to the natural wear of the valve itself, and he underwent the second replacement surgery. In that case, the first section of the aorta, which had become aneurysmatic, had also been replaced. However, the third replacement surgery was sudden: an unexpected valve insufficiency brought him back to the hospital. Today Samuele, after two months, is fine: “I’m surprised that the recovery was so fast – he says -, already after the operation, when I was in intensive care, I felt better than in previous operations. Many thanks to Maria’s team at Pia Hospital and Dr. Del Giglio”.