How a smart wire helps during heart surgery

Catharina Hospital is the first hospital in the Netherlands to use a smart wire when replacing the aortic valve with a so-called TAVI procedure. This may give a better surgical outcome for the patient.

TAVI stands for Transcatheter Aortic Valve Implantation. It is a treatment technique in which our doctors at the Heart Center replace the diseased aortic valve “percutaneously. That is, through the femoral artery. In a TAVI, the interventional cardiologist places an aortic artificial valve made of biological material using a catheter (tubing).

“What's going to change now is that we no longer use a simple steel wire in this operation to slide the new valve over and pacify (get the heart into the right rhythm), but a smart wire. In other words, with technology in it,” explains interventional cardiologist and professor Pim Tonino. “There are 2 aspects to the new wire, which is called SAVVY wire: the SAVVY wire is completely insulated so that the current through the wire is routed better and you can be sure of pacing at all times, which is very important for this procedure.”

The second plus of the smart wire is the pressure sensor at the end of it. “That continuously measures the pressure in the left ventricle. That's virgin territory; we don't know that at all. First, you could only measure the pressure at the beginning and at the end of the operation, but not all the steps in between. Until now, that is. Now we have a continuous view of it from now on. And with that, we can further optimize the TAVI.”

Profit for the patient

What is ultimately the gain for the patient? “The surgery takes less time and you don't have to pacemaker the heart as much, making the surgery less intensive. And the end result - fewer complications - may also be better, because you can make better decisions as an operator during the operation based on those continuous pressure measurements,” said Tonino, who also sees another important reason for deploying the SAVVY wire: the cost aspect.

More innovations in the Netherlands

More innovative methods of cardiac surgery are being used in the Netherlands. The HagaZiekenhuis was the first hospital in the Benelux to open an MRI Ablation Center for heart surgery. In this center, an innovative method is used to treat cardiac arrhythmias: electroporation ablation. This technique uses current pulses instead of traditional freezing or heating methods.

The Netherlands is also innovative in terms of heart-lung machines. St. Antonius Hospital was the first in the Netherlands to introduce a state-of-the-art heart-lung machine in 2019. This advanced machine supports the patient's circulation and lung function during (open) heart surgery. The device is designed to speed up patients' recovery after surgery and also offers greater ease of use.

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