The Heart Valve Center at IRCCS Ospedale San Raffaele celebrates its 5th anniversary

In 2024, the Valve Center confirmed its excellence by performing 1,267 procedures with a post-operative mortality rate of just 0.8% among elective surgery patients, a figure significantly below predicted risk model estimates, demonstrating the high quality of its clinical protocols.

Among the most significant procedures, 488 patients were treated for mitral valve disease:

• 239 patients underwent surgical mitral valve repair, a technique that preserves the native valve by correcting structural defects using support rings or leaflet repair;
• 114 patients received percutaneous interventions, such as MitraClip and Pascal device implantation, which reduce mitral regurgitation without requiring open-heart surgery.

The overall surgical mortality rate was 0%, while for percutaneous procedures it stood at 1.8%, considerably lower than the expected 3.9%.

The Center also treated 280 patients with aortic valve disease:

• 114 underwent surgical valve replacement, 85% of which were performed using minimally invasive techniques to reduce surgical trauma and accelerate recovery;
• the remaining 166 patients were treated with transcatheter aortic valve implantation (TAVI), an innovative approach that replaces the diseased valve via catheter, usually through the femoral artery, without removing the old valve. Pioneered by the center in 2003, this method restores normal blood flow with minimal patient impact.

The results were excellent: surgical mortality was 0%, while TAVI mortality was 1.8%, significantly below the expected 4.6%.

Additionally, the Valve Center recorded a sharp increase in the treatment of tricuspid valve disease, tripling the number of procedures in just five years thanks to a combined approach of traditional surgery and interventional techniques. In 2024, 193 interventions were performed, with a notable reduction in overall mortality from 10% in previous years to 2.7%. This improvement is attributed to the adoption of less invasive techniques that lower surgical risk and improve patient outcomes.

The success of the Valve Center lies in a patient-centered, multidisciplinary approach, combining top-level medical, surgical, and technological expertise. The team includes surgeons, interventional cardiologists, clinical cardiologists, intensivists, and imaging specialists who work synergistically to deliver personalized care. Treatment options include minimally invasive endoscopic techniques, advanced transcatheter procedures, and experimental trials for high-risk and complex cases.

In collaboration with the Università Vita-Salute San Raffaele, the Center also plays a crucial educational role, helping young cardiac surgeons and cardiologists develop their skills by:

• Simulating complex procedures on cutting-edge 3D models;
• Enhancing their medical-surgical training;
• Reducing the risk of error during the learning curve.

Simulation has proven essential in minimizing surgical risk and improving the effectiveness of procedures.

The Center also partners with leading companies in medical devices, artificial intelligence, and augmented reality to test and refine state-of-the-art surgical tools, expanding its therapeutic capabilities in line with the latest innovations. This allows the Center to offer patients ever safer and more effective surgical solutions.

Additionally, San Raffaele supports remote interventions via teleproctoring, extending the expertise of its professionals to other hospitals and helping improve outcomes in less experienced centers.

By constantly monitoring results, adopting new technologies, and investing in ongoing staff training, the Heart Valve Center at Ospedale San Raffaele continues to raise the standard of care, with the goal of providing safe, effective, and transparent treatments, and embracing a philosophy of continuous improvement.

“We are proud of the results achieved over these five years. Our mission is to keep innovating and refining treatments, offering every possible solution and tailoring the ideal one to each patient,” concludes Professor Maisano.