Mr Kishore Doddakula
Clinical Lead, Cardiothoracic Surgeon, Cork University Hospital & Bon Secours Hospital Cork
Prof Lars Nölke
Consultant Cardiothoracic and Transplantation Surgeon at Our Lady’s Children’s Hospital, Crumlin, and Mater Misericordiae University Hospital
Consultant cardiothoracic surgeons highlight innovations in surgical valve replacement for structural heart disease, including novel tissue valves designed with the future in mind.
Structural heart disease (SHD) refers to a range of conditions affecting the heart’s veins, valves, walls, chambers or muscles, leading to impaired heart function. Symptoms include fatigue, palpitations, chest pain, shortness of breath and syncope. It’s estimated that around 14 million people in Europe suffer from SHD,1 making it a significant public health crisis. “Around 50% of patients with SHD need surgical correction for valvular heart disease,” explains Mr Kishore Doddakula, one of the few cardiothoracic surgeons in Ireland to perform minimally invasive surgical aortic valve replacements. “Each patient is situation dependent, and decisions are made between repair or valve replacement, tissue or mechanical, surgical or percutaneous, and considering age, anatomy and overall health.”
Innovations in valve management
While mechanical valves may be more favourable in younger patients, offering enhanced durability, patients are required to take lifelong blood-thinning medication. As an alternative, Edwards Lifesciences has developed an innovative RESILIA tissue valve, a next-generation bovine pericardial heart valve.
“One of the main advantages is its anti-calcification technology, which addresses a major concern with tissue valve durability,” explains Doddakula. “These valves are designed with the future in mind, meaning that if a patient needs a transcatheter valve in the future, it can be implanted through the groin without removing the existing valve.”
“Edwards seems to be listening closely to what patients and the cardiology community need,” adds Professor Lars Nölke, consultant cardiothoracic surgeon, “as these newer valves are designed to set patients up for lifetime management, and intermediate data from the COMMENCE clinical trial appear to be very good.”
Edwards Lifesciences has developed an innovative RESILIA tissue valve, a next-generation bovine pericardial heart valve
Data-driven decision-making
Doddakula leads cardiac surgical training sessions in Ireland in collaboration with Edwards, specifically focusing on the skills needed to perform minimally invasive approaches. “Surgeons often work in collaboration with industry to advance available treatments,” explains Doddakula. “I work closely with just Edwards, which plays a major role in facilitating training for clinicians on the latest technology and techniques to improve patient outcomes.”
“The goal posts are changing all the time, making the need for education and awareness of clinical data extremely important,” explains Nölke. “Over the next two years, the way data is being reported across Ireland will reshape both clinical and general understanding of these novel technologies. With transparent real-world data on outcomes, procedural success and long-term valve performance will facilitate informed decision making and success.”
