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San Donato Polyclinic on the cutting edge for interventional cardiology

MILAN (ITALPRESS) – Innovative and minimally invasive procedures to treat aortic stenosis, robotic platforms to intervene in acute myocardial infarction, and the first transcatheter mitral valve replacement, conducted for compassionate use, to treat mitral insufficiency: the IRCCS Policlinico San Donato in Milan is recognized as an excellence in the treatment of cardiovascular diseases, where we already glimpse the future of interventional cardiology. Dr. Francesco Bedogni, director of the Clinical, Interventional Cardiology and Coronary Intensive Care Unit (CICU) at IRCCS Policlinico San Donato, explained some of the most innovative procedures in his area, starting with the difference between a classic coronarography, versus one with coronary flow assessment, performed with advanced blood flow analysis instrumentation, to obtain a more accurate assessment of the coronary problem. “Coronarography is the standard method of making a diagnosis of coronary artery disease and preparing us for its treatment. The examination allows us to detect any places where the coronary arteries are narrowed (stenosis) or closed (occlusions) and to plan possible interventions, such as, for example, coronary angioplasty. Thanks to advances in diagnostic imaging, applied to the heart, during current coronary procedures, a functional assessment of blood flow is also possible, in addition to an accurate analysis of plaque characteristics with intravascular echo or real-time OCT, in order to be able to treat the patient in the most appropriate way. “IRCCS Policlinico San Donato boasts the record in Italy for Transcatheter Aortic Valve Implantation (TAVI). “Having the possibility,” Bedogni further told Italpress, “to treat patients with a minimally invasive technique, under local anesthesia, by inserting a prosthesis, which is compressed inside a catheter, introduced into the femoral artery and advanced until it reaches the stenotic valve, is an undoubted advantage for elderly or higher-risk patients, both in terms of recovery and avoiding extracorporeal circulation. Policlinico San Donato is, then, the only center in Italy to have a state-of-the-art robotic assistance platform, ‘Robocath,’ capable of ensuring very high quality standards in the field of angioplasty and peripheral or carotid interventional procedures, with the non-secondary advantage of total protection from x-rays and less radiological exposure for the operator. “The robot,” Dr. Bedogni further explained, “has already been widely used in surgery. These are the first experiments, as far as interventional cardiology is concerned. We manage to be extremely precise in navigating within the vascular system, moving simple joysticks, and with the added advantage of standardizing the procedure for all operators. “Looking to the future of mitral insufficiency treatment, at IRCCS Policlinico San Donato, the first transcatheter mitral valve replacement (TMVR) was performed on a compassionate basis on an 81-year-old man in Italy with the CardioValve RM XL device. “The present of the mitral valve is its repair. The procedure uses a “clip,” which is a kind of paperclip that is hooked onto the mitral valve leaflets and allows us to reduce the valve insufficiency that is a very common occurrence in elderly and decompensating patients. We are, however, already experimenting with several other devices so that, in the future, it will probably be possible to flank this treatment with the replacement of the valve itself, which could become a new alternative for the treatment of patients with severe mitral insufficiency at high or prohibitive operative risk,” Dr. Francesco Bedogni concluded.-photo f03/Italpress-(ITALPRESS)