Clínica Valladolid, pionera en reemplazo de prótesis aórticas mecánicas por cateterismo

Professionals from the Cardiology Department at the University Clinical Hospital in Valladolid performed the replacement of aortic mechanical prostheses in what is a worldwide milestone that has sparked interest from other Spanish healthcare centers. This achievement is linked to a research project in collaboration with the National Cardiovascular Research Center.

Aortic stenosis is the narrowing of the left ventricle of the heart, a common condition among the elderly population in Castilla and León due to the aging demographic. When a patient presents symptoms, the prognosis is very unfavorable, with half of the patients succumbing within three to five years unless a prosthesis is implanted.

Until recently, the only option was a surgical procedure known as «open-heart surgery,» where the damaged native valve was replaced with a biological or mechanical prosthesis. Nowadays, thanks to advancements in medical technology, the implantation or replacement can be done percutaneously, without surgery, through a procedure called «TAVI» (Transcatheter Aortic Valve Implantation).

Implementing this procedure in patients with mechanical valves, especially those with metal discs that complicate valve opening and the placement of the prosthetic valve, posed significant risks and challenges. The University Clinical Hospital in Valladolid has achieved a groundbreaking milestone by successfully replacing an aortic valve using a catheter without the need for surgery.

The patient, a 76-year-old man who underwent complex surgery in 2003 to replace his aorta and aortic valve with a prosthesis, experienced worsening symptoms in 2025. Tests revealed that the surgical prosthesis was not functioning properly, as both mechanical discs were virtually immobile. Due to the high risk involved in a new surgery, an innovative approach was needed.

Prosthetic heart valves can be mechanical or biological, each with its own set of advantages and limitations. Mechanical valves are durable but require lifelong anticoagulant therapy, while biological valves have a shorter lifespan but allow for less invasive re-intervention if needed.

The technique utilized in this case, developed after extensive laboratory experiments and animal studies, involved the extraction of the malfunctioning discs from the mechanical prosthesis and the percutaneous implantation of a new prosthesis without the need for open-heart surgery. This procedure, a first of its kind, was performed successfully, avoiding the risks associated with a repeat surgery.

The team responsible for this groundbreaking procedure at the Valladolid Hospital included Dr. Ignacio Jesús Amat Santos, Dr. Mario García Gómez, and Dr. Blanca de Prada Martín, under the leadership of Dr. José Alberto San Román Calvar, Head of the Cardiology Department and Director of the Heart Sciences Institute.

Following the successful intervention, the patient’s health improved significantly, allowing for a return to normal life. This medical milestone is part of a research project conducted by the Valladolid Clinic and the Heart Institute of Sciences (ICICOR) in collaboration with the National Cardiovascular Research Center «Carlos III» (CNIC) focused on advancements in aortic mechanical prostheses.

This research project received support from Dr. Borja Ibáñez Cabeza, Scientific Director of the National Cardiovascular Research Center (Carlos III Health Institute), who collaborated in the initial research phase and provided access to the necessary facilities for the experiment. Dr. Carlos Real Jiménez, a researcher at CNIC, was also involved during the aortic procedure.

Following the success of this groundbreaking innovation, several hospitals in Spain have expressed interest in replicating the procedure and have sought collaboration with Valladolid for the treatment of patients in need.

FUENTE