Belgian Hospital Implants ‘Forgotten Heart Valve’ in European First
AZ Sint-Jan Hospital in Bruges has made European medical history by successfully implanting a tricuspid heart valve — known in medical circles as the “forgotten valve” — without performing open-heart surgery. The groundbreaking procedure, carried out via a catheter inserted through the jugular vein, offers new hope for elderly and frail patients who were previously considered inoperable.
According to VRT NWS, the surgery took place approximately two weeks before the 28 May announcement. The patient, an elderly woman, is recovering well under the supervision of a specialized team of cardiologists and anesthesiologists.
The ‘Forgotten Valve’
The tricuspid valve is one of the four heart valves, located between the right atrium and right ventricle. When it leaks — a condition known as tricuspid regurgitation — blood flows backward, causing severe shortness of breath, fluid buildup in the legs, and eventually heart failure.
In the medical world, the tricuspid valve has long been called “the forgotten valve” because treatment options were severely limited. While minimally invasive catheter-based techniques existed for the aortic and mitral valves on the left side of the heart, no such option was available for the tricuspid valve until recently. Patients who were too old or frail for open-heart surgery were often left with only medication, which provided insufficient relief.
The scale of the problem is substantial. Approximately 280,000 Belgians have a leaky tricuspid valve, and more than 50% of patients with moderate to severe tricuspid regurgitation die within three to four years without intervention.
A Minimally Invasive Breakthrough
The procedure — known as transjugular transcatheter tricuspid valve replacement (TTVR) — was led by cardiologists Dr. Jan Van Der Heyden, Dr. Philippe Debonnaire, and Dr. Ian Buysschaert at AZ Sint-Jan Brugge.
“For relatively young people, we consider performing open-heart surgery to repair or replace the valve,” Dr. Van Der Heyden explained. “People who are a bit older or weaker due to lung or kidney issues cannot undergo open-heart surgery. It’s too risky.”
Traditional open-heart surgery requires stopping the heart and using a heart-lung machine — a procedure that carries a 15% mortality rate during surgery and another 15-20% within a year. The new catheter-based approach dramatically reduces these risks.
“We inserted the new valve through a small incision in the jugular vein and positioned it precisely in the correct spot, entirely without open-heart surgery,” Dr. Van Der Heyden said. “The procedure is performed with only a small incision, without touching or damaging major structures in the heart. This also results in a shorter recovery period than traditional heart surgery.”
International Collaboration
The European first was made possible through international cooperation. American and Australian doctors who had previously performed the technique were present to assist during the procedure, ensuring that all global expertise was concentrated in a single operating room.
“The focus and concentration rises from 110 percent to 120 percent,” Dr. Van Der Heyden noted. “The operation took place two weeks ago and that elderly woman is doing well.”
The procedure also represents a breakthrough in cardiac imaging. “We can’t see through the body, so we need special ultrasound techniques for that,” Dr. Van Der Heyden said. “These are often complex, but now we can better visualise the right side of the heart, and specifically that tricuspid valve.”
A Track Record of Innovation
AZ Sint-Jan Brugge has a history of pioneering cardiac procedures. In November 2022, the same team performed a “first in West-Europe” tricuspid valve replacement using a catheter technique via the femoral vein, as reported by Plus Magazine. The 2026 procedure advances this further by using the jugular vein approach, which offers a more direct route to the tricuspid valve and may be preferable for certain patient anatomies.
What This Means for Patients
This is the second time this specific transjugular procedure has been performed worldwide, following an initial case in the United States. For the estimated 1.5 million Americans and hundreds of thousands of Europeans living with tricuspid regurgitation, the technique opens the door to treatment for those who previously had no good options.
As the technology matures and more procedures are performed, transjugular tricuspid valve replacement may become the standard of care for tricuspid regurgitation, replacing open-heart surgery for many patients. The minimally invasive approach is also likely to be more cost-effective due to shorter hospital stays and reduced complications.
Looking Ahead
The success at AZ Sint-Jan Brugge positions Belgium at the forefront of transcatheter valve technology in Europe. Questions remain about the long-term durability of the implanted valve, reimbursement decisions by Belgian health authorities, and the training pathway for other European cardiologists to learn this technique. However, for the thousands of patients who have been told they are too frail for surgery, this European first represents a new chapter in cardiac care.