World Heart Day, which falls on 29 September, called for care for one of the most important organs in the body and for early treatment of any problems.

The most common heart valve defect is aortic stenosis (narrowing of the valve), which mainly affects patients over the age of 70. “Treatment with medication is not effective in the long term as it only leads to temporary relief of symptoms. Valve replacement is necessary, either by cardiac surgery, i.e. a major open-heart operation, or increasingly by catheterisation. In fact, if surgery is not performed, the prognosis for a large proportion of patients is worse than for some cancers. However, if patients address their problems early, the procedure can extend and improve their lives by many years,” explains doc. MUDr. Martin Mates, CSc., head of interventional cardiology at the Cardiac Centre of the Hospital na Homolce.

Patients often postpone the procedure due to fear of major heart surgery and general anaesthesia. However, their condition usually deteriorates rapidly. While weeks of convalescence are necessary after a major open-heart surgery, in the case of aortic valve catheterisation using the TAVI method, patients are back to “normal” within a few days.

In a minimally invasive procedure, the valve is inserted into the heart via a catheter, most often through an artery in the groin. The procedure is usually performed under local anaesthetic and after four days the patient usually leaves hospital for home treatment. The TAVI method is a hope for patients for whom conventional surgery is too much of a risk.

TAVI procedures, which are fully covered by public health insurance, are carried out around 1,300 a year in this country, but the capacity of specialist facilities is twice as high.

The Královské Vinohrady Faculty Hospital has opened a new intervention cardiology centre. The modernized centre will permit more rapid and more precise diagnostics and treatment of patients with acute myocardial infarction, ischemic heart disease, diseases of the heart valves, and acute stroke.

Integration of imaging methods during transcatheter aortic valve implantation (TAVI) will enable rapid and simpler operations with minimum stress and with the possibility of early release into home care. In terms of the number of operations the Cardio Centre ranks among the most important centres in the Czech Republic.

Modernization of the Division of Intervention Cardiology at the Cardio Centre of the Královské Vinohrady Faculty Hospital was possible thanks to support from EU Structural Funds and winning a competition for long-term sectoral collaboration. One of the conditions was association with an innovative firm and this is why the hospital contacted Medtronic. “We are happy that we can as the world leader in the development of medical  technologies take part in such an interesting project. We believe it will provide access to modern treatment for a greater number of Czech patients,” said Michal Vondraš, CEO of Medtronic Czechia s.r.o. “Thanks to our long-term work with healthcare data and experiences from abroad we can help to raise the standard of and care for people with cardiovascular complaints and patients after apoplexy – to treat more patients, more gently and more safely.”

The association aims to combine clinical research with the employment of state-of-the-art diagnostic and treatment methods delivered to patients with severe cardiovascular complaints and, at the same time, to optimize the current treatment procedures. Further research will focus on ways of improving the availability, effectiveness and safety of intervention treatment of patients, and the issue of bioabsorbable stents, in which the Cardio Centre Královské Vinohrady ranks among the very best in the world.

The Královské Vinohrady Faculty Hospital Cardio Centre consists of two clinics: Cardiology (chief physician Prof. MUDr. Petr Widimský, DrSc.) and Cardio Surgery (chief physician MUDr. Petr Kačer, PhD.). Between 6,000 and 7,000 patients are hospitalized at the Cardio Centre every year. In terms of results, the FNKV heart centre ranks among the best in the Czech Republic and is fully comparable with the leading institutes worldwide.

Czech deputy Karel Schwarzenberg has undergone an operation of the cardiac valve which doctors had replaced in the past. 

Prince Schwarzenberg has undergone a cardiac valve replacement through the femoral artery – a transcatheter aortic valve implantation, known in the Czech Republic under the acronym TAVI. After demanding months when he grappled with serious problems he is recovering well thanks to the successful operation.

A complication for Karel Schwarzenberg was his allergy to heparin, an anticoagulant. As general anaesthesia was out of the question, the politician was only administered by the team of doctors local anaesthesia. Although Karel Schwarzenberg had after the operation some slight speaking problems, he is slowly returning to normal life and is even thinking of politics.

Legendary frontman of the rock group Rolling Stones, Mick Jagger, has had a cardiac valve replacement operation.

Doctors have carried out for the legendary frontman what is known as a transcatheter aortic valve implantation (TAVI), which is one of the most often used alternatives to a surgical valve replacement as it does nor necessitate that the chest be opened.

The alternative intervention allowed the legendary rocker a shorter stay in the hospital and more rapid recovery. Jagger thanked on his Twitter for support messages and for a great team of doctors that had looked after him. He told his fans that he was doing much better and is fully recovering. However, as a result of these medical complications The Rolling Stones had to postpone their tour of the United States.

David Kupka was an active, healthy man in the thick of it: he was running a large lodging facility with a catering operation, devoting himself to his three children, and playing sports to the fullest when heart disease intervened in his life.

It was not the first time he faced a serious illness. He had to fight it at the age of 21, when he underwent several cycles of chemotherapy and radiation, but Hodgkin’s disease was successfully cured. However, after his 37th birthday, the damage to his heart became apparent. In 2018, doctors offered him a major open-heart surgery, but Mr. Kupka did not want to go through with it. Because he felt well, he declined the surgery.

“At the time I felt healthy and fine, I was playing sports, devoting myself to my family and I didn’t want to sacrifice months of recovery again. The only thing that bothered me was a higher heart rate, but it was bearable, so I didn’t even take medication. For almost three years, until I was 49, it worked fine, but then there was a sudden deterioration. Suddenly I couldn’t breathe, I couldn’t sleep, I was propped up with pillows in bed, I felt like I was drowning. It was really terrible, the “downhill” was terribly fast, within a few weeks. I was really sick, so my wife took me to the ICU. There they did an examination, took 3 litres of water out of my body and started preparing me for a heart valve replacement. Dr. Želízko chose the minimally invasive TAVI method, without much cutting, so I was very happy to agree,” says Mr. Kupka.

The preparation for the surgery included a number of examinations, but these took place directly at the IKEM during the 11-day hospital stay. Mr Kupka then rested at home for a few days and then started the procedure. The whole thing did not take more than five days – arrival, the operation itself, 3 days on the bed and then straight home. “I was conscious during the procedure and communicated normally. The doctors replaced my coat with a catheter inserted into my femoral artery, and after the operation, instead of a cut chest, I only had catheter punctures. My heart rate was almost immediately after the procedure, I left the hospital by taxi and I felt great,” recalls David Kupka.

One year after the operation, the valve is working exactly as it should. My heart rate has dropped, my heart is “keeping up” and it allows me not only to function normally and to do the demanding work of a real estate entrepreneur, but also to play recreational sports, cycling, running, skiing, hiking with my family and finding answers to my youngest child’s constant nagging questions. He is happy with the functioning, he does not know about the valve.

“I can only recommend the TAVI heart valve replacement. The valve works without any problems, the heart rate has decreased and I feel good, although I am not saving myself in any way. It’s a pity that many people don’t know about the possibility of a minimally invasive procedure, within a few days their lives could be greatly improved. And I know from my own experience that problems need to be addressed early,” concludes David Kupka. astní zkušenosti vím, že potíže je třeba řešit včas,“ uzavírá David Kupka.

Alena has been living an active lifestyle for 77 years. She spent many years doing technical drawing, as well as educating herself on classical music; she spent years singing with the Czech Madrigalists or performing in Realistic theatre, now known as Svandovo Theatre in Prague. She spent her entire life surrounding herself with artists – her brother-in-law was a sculptor and painter, her sister is a painter and illustrator, and her other family members are involved in the arts as well.

She never wasted her life, spending a long time looking after her ill and aging relatives, looking after her family, her house and garden, and now she is currently looking after her ill sister. Because of her busy lifestyle, she often experiences health issues. Her mother had heart problems, which is why Alena had been monitored for a long time, but the doctors hadn’t found anything, which is why, when she had breathing difficulties and fatigue three years ago, she assumed it was age-related and tried to overcome it, despite it being difficult. She made an appointment at a Vinohrady hospital in Prague only when her neighbour, a cardiology nurse, noticed her issues with breathing and fatigue. The doctor confirmed there was something wrong with her heart valve and suggested surgery. „The doctor recommended replacing my heart valve using the TAVI method, inserting a catheter into my groin. This way I could avoid an open heart surgery with a long convalescence period and I could quickly return ‘back to business‘, so I happily agreed to go through it,“ says Alena.

The TAVI procedure is especially useful for seniors, as it is done laparoscopically. The patients can, then, avoid going through a big cardiac surgery on the heart, and only deal with having a catheter inserted into their groin. Returning to normal life, then, is almost immediate and there is little risk of complications, resulting from spending a significant amount of time in a hospital bed.

After the surgery, Alena was hospitalized for two days, during which she had undergone various necessary health examinations, after which she went in for the actual surgery. She was under anesthesia the whole time, so she does not remember much from the surgery. After getting her valve replaced, she spent three days in the Intensive Care Unit and another three days in a regular room. Then she was allowed to go home. „I felt amazing after the surgery. My breathing difficulties subsided, I stopped having shortness of breath and my fatigue had gone away as well. Suddenly I had a ton of energy and motivation. When I got home, I tried to conserve my energy by not picking up heavy things and stuff, but otherwise I was functioning normally without any issues,“ she adds. She was supported by her partner whom she has been with for 6 years. Currently, she spends her time doing hobbies she enjoys, working on the house and garden, having an active life with her partner, taking care of her sister and spending time with her family – she has a daughter, two granddaughters, two great-grandsons and two great-granddaughters.

When eighty-five years old psychotherapist Petr Riesel appeared in his future operating surgeon’s consulting room, his complaint was advanced. He was suffering from a narrowing of the aortic valve known as stenosis.

In addition, Doctor Riesel had problems with both hips and was refused an operation because of stenosis. An operation would be too risky and Doctor Riesel might not survive it. But it was precisely his age, the high risk a classic operation would entail, and limited mobility as the decisive factors that paradoxically opened Petr Riesel’s door to a heart valve replacement employing the gentle method TAVI. Doctor Riesel felt markedly better right after the operation and can still practice his psychotherapeutic profession without major limitations.