Hospital da Luz Lisboa successfully performed, on June 15, its first percutaneous mitral valve-in-valve implant on an 83-year-old patient. The intervention, exclusively by catheterization, consisted in placing a mitral valve inside an already existent and worn-out biological mitral valve, which was causing cardiac insufficiency and a rather complex clinical condition. This was the first time the procedure was performed within the Hospital da Luz group . And it allowed to avoid submitting the patient to conventional surgery for replacement of the worn-out valve, which would have been highly risky. The patient had previously been submitted to two cardiac interventions (the last one about ten years ago), both involving biological mitral prostheses implantation. In April 2025, she suffered from prosthesis endocarditis (infection). The clinical evolution caused cardiac insufficiency that did not seem to improve despite the medical and pharmacological therapy applied. The diagnosis, research, clinical follow-up, and therapeutic decision work was conducted by cardiologist Lígia Mendes and Hospital da Luz Setúbal Cardiology service. After case discussion in multidisciplinary team, percutaneous treatment was proposed given the high complexity and risk of a new conventional surgery. The procedure was performed at Hospital da Luz Lisboa by a team comprising interventional cardiologists Rui Campante Teles , Sérgio Madeira and Henrique Mesquita Gabriel, cardiac surgeon Tiago Nolasco , cardiac imagiologist Marisa Trabulo and anaesthesiologist Filipa Aguiar . The new prosthesis was percutaneously implanted by transseptal approach, minimally invasive, guided by fluoroscopy and 3D echocardiogram – techniques that have allowed positioning the valve with high precision, with no need to open the chest or resort to extracorporeal circulation. The whole intervention proceeded without complications and the patient was released from hospital after two days, with substantial improvement of the clinical condition and good evolution to date. This case clearly illustrates the capacity of articulation between specialists and different units within Hospital da Luz network, as well as the importance of multidisciplinarity and how decisive are minimally invasive structural intervention techniques in the treatment of patients with complex valvular disease and high surgical risk, representing a safe and effective alternative to conventional surgery, enabling a faster recovery and shorter hospitalization time. Another exemplary case Already in 2025, Hospital da Luz Lisboa had been the stage of another exemplary clinical case, that of a 95-year-old patient, equally illustrative of the potential of minimally invasive techniques. This patient was submitted to two percutaneous valvular procedures by the Interventional Cardiology team: one for replacement of the aortic valve by a biological valve (conducted by Sérgio Madeira , in March), and the second consisting in an urgent percutaneous mitral valvuloplasty resorting to PASCAL Ace device (conducted by Rui Campante Teles , in June). This case emphasises how percutaneous techniques are truly transformative, proving that it is possible even in advanced years to obtain significant clinical benefits and better quality of life by investing in an adequate and integrated approach. It is also worth mentioning the exemplary collaboration in this case between Hospital da Luz units (Oeiras and Lisboa) , ensuring convenience to the patient and access to highly differentiated teams and leading-edge technology. The role of advanced imaging exams was fundamental in all stages of diagnosis and procedure- “Such cases prove that age per se should not exclude patients from the most innovative and effective solutions in interventional cardiology, upon thorough evaluation by experienced multi-institutional teams”, points out Rui Campante Teles.
