Severe tricuspid valve regurgitation is a serious heart condition. The development of tricuspid valve implants is still in its early stages, with only a few models tested in the country so far. Charles was the first patient in the UK to receive a newer implant, which aims to be more accessible to a wider range of patients.
Charles Kerry, an 82-year-old opera singer from Lewes, became the first patient to receive an innovative heart valve replacement as part of a research study for severe right heart valve disease. This marked a significant milestone for University Hospitals Sussex, and remarkably, Charles was back home the very next day.
Charles had experienced severe tricuspid valve regurgitation for the past four years. This condition, commonly experienced in older adults, occurs when the valve doesn’t close properly, causing blood to flow backward instead of moving forward to the lungs. People can experience debilitating symptoms, such as breathlessness, excess tiredness and leg swelling.
Charles underwent this procedure at the Sussex Cardiac Centre at Royal Sussex County Hospital in February, as part of a study assessing the safety and efficacy of a new valve implant.
Treatments typically used for this condition have been limited to open-heart surgery, but this is a high risk for this group due to age, frailty, or other health conditions, making the condition untreatable for some.
Transcatheter tricuspid valve replacement (TTVR) offers a minimally invasive alternative that avoids open-heart surgery. Like Transcatheter Aortic Valve Implantation (TAVI), which focuses on the aortic (left) valve, TTVR specifically targets the tricuspid (right) valve. It uses innovative technology to insert a thin tube through a vein in the groin that’s guided to the heart and delivers a new, artificial valve to replace the diseased valve, helping restore normal blood flow.
Reflecting on the experience, Charles said: “I was hardly nervous at all. There was no question for me to say no thanks to having this procedure.
“I’ve certainly seen an improvement, even if it just stopped me deteriorating which I was in the final weeks before the procedure.”
A keen walker, Charles was delighted to resume walking so soon, he said: “Two days after the procedure, with an escort, I walked up a steep road. I did feel rather smug. I’m better walking uphill already and can do a couple of miles with a stick.”
Charles is recovering well at home and is set to make a return to the stage very soon.
When the right side of the heart is not working properly, this condition will eventually affect the left side, which can lead to heart failure and be life threatening. With it estimated that 1% of the population will end up with this condition, being able to offer alternative treatment options is vital to improving patient outcomes and quality of life.
Professor David Hildick-Smith, Consultant Cardiologist, who led the team, said: “We were really pleased to be able to offer Charles this new valve implant. It looks a little bit like a poached egg as it slides slowly into place in the heart and the whole procedure took a couple of hours, so it was a well-done poached egg by the end!
“At the moment, we have relatively few options for patients with severe tricuspid regurgitation. We can offer tablets, or surgery, but nothing much in between. Surgery is a big deal in older patients, and we try to avoid this where possible. So, the arrival of implantable valves that we can position from a vein in the leg is a hugely exciting development, paving the way for many other similar patients to have this procedure over the coming years. And Charles will always have been the first!”
This achievement is thanks to the dedicated efforts of the multidisciplinary team involved, including nurses, cardiologists, radiologists, anaesthetists and imaging, who displayed immense teamwork and professionalism to make this possible.
The team continues to monitor patients from cardiac clinics who may benefit from being a part of this research study, using thorough screenings to ensure they are suitable candidates for this procedure.
Jessica Parker, Lead Research Nurse, played a crucial role in coordinating the complex process of enrolling Charles as the UK’s first recipient in the study.
She said:” We are now seeing quite a few patients like Charles with this condition being considered for a study of an implantable valve. Sometimes people cannot be enrolled in the trial for one reason or another, so we were very pleased when all the tests came back positive for Charles. Hopefully he is the first of many now. It is potentially going to usher in a big change in the way we manage these patients and could be the breakthrough required for treating all patients with tricuspid valve regurgitation.”
As part of the study, Charles, along with future patients who take part, will be closely monitored over a five-year period to assess the effectiveness of this treatment.
This study aligns with UHSussex’s Research and Innovation Strategy, which outlines a five-year plan for advancing healthcare research and innovation to ensure excellent care for all patients in Sussex.