Istanbul, Denizli, and Izmir, Turkey — July 22-24, 2025 — The VitaFlow Liberty® Transcatheter Aortic Valve and Retrievable Delivery System (VitaFlow Liberty®), independently developed by MicroPort CardioFlow Medtech Corporation (02160.HK), has successfully completed the first five commercial implantations in Turkey. These procedures mark the official entry of VitaFlow Liberty®, the world’s first motorized retrievable TAVI product, into Turkey, a transcontinental nation bridging Europe and Asia with a large population.
The procedures were guided by Prof. Jian’an Wang, an academician from the Second Affiliated Hospital of Zhejiang University, and Prof. Xianbao Liu, and were performed by Prof. Dr. Teoman Kilic from Kocaeli Üniversite Hastanesi, Prof. Dr. İsmail Doğu Kılıç from Pamukkale Üniversitesi Denizli Hastanesi, and Prof. Dr. Hakan Güneş from Tepecik EAH İzmir Hastanesi. Postoperative evaluations showed no significant paravalvular leakage or other complications in all five patients across the three hospitals, confirming the complete success of the procedures.
Case 1
The patient was a 91-year-old female with a tricuspid aortic valve and severe stenosis. CT measurements revealed an annulus circumference of 64.8 mm (mean diameter: 20.2 mm), an LVOT (left ventricular outflow tract) circumference of 66.6 mm (mean diameter: 20.3 mm), sinus widths of 28.3 mm / 29.5 mm / 30.1 mm, an STJ (sinotubular junction) mean diameter of 27.0 mm, an ascending aorta mean diameter of 31.8 mm, and an annulus angle of 50°.
This was a case of severely calcified tricuspid valve, with calcification extending into the outflow tract, posing a potential risk of paravalvular leakage (PVL). Due to the patient’s risk of left coronary artery occlusion, the teaching experts and operators decided to use an 18 mm balloon for pre-dilation angiography to assess coronary risk and assist in valve sizing. If a TAV21 valve was selected, high implantation would be performed; if a TAV24 valve was chosen, standard implantation would be adopted.
After 18 mm balloon pre-dilation, the TAV24 valve was selected. Mild residual PVL was observed post-implantation, so a 20 mm balloon post-dilation was performed. The final result showed a 4 mmHg pressure gradient, no significant PVL, an implantation depth of 2 mm at the non-coronary sinus and 5 mm at the opposite leaflet, and no other complications.
Case 2
The patient was an 82-year-old female with a tricuspid aortic valve, severe stenosis, and moderate regurgitation. CT measurements revealed an annulus circumference of 60.8 mm (mean diameter: 19.5 mm), an LVOT circumference of 58.7 mm (mean diameter: 18.3 mm), sinus widths of 37.6 mm / 28.4 mm / 28.9 mm, an STJ mean diameter of 25.4 mm, an ascending aorta mean diameter of 32.9 mm, and an annulus angle of 49°.
This was a classic tricuspid valve case with thickened and severely calcified leaflets. The annulus size was between the TAV24 and TAV21 models of VitaFlow Liberty®. Given the heavy calcification and thickened leaflets, the operator determined that the straight-frame stent and supra-annular valve design of the product would provide better effective orifice area. Thus, an 18 mm balloon pre-dilation was performed, followed by implantation of the TAV21 valve with high positioning.
The final result showed no pressure gradient, no significant PVL, an implantation depth of 1 mm at the non-coronary sinus and 4 mm at the opposite leaflet, and no other complications.
Case 3
The patient was an 82-year-old female with a tricuspid aortic valve and severe stenosis. CT measurements revealed an annulus circumference of 77.1 mm (mean diameter: 23.9 mm), an LVOT circumference of 80.0 mm (mean diameter: 23.1 mm), sinus widths of 31.9 mm / 31.6 mm / 29.3 mm, an STJ mean diameter of 30.5 mm, an ascending aorta mean diameter of 34.4 mm, and an annulus angle of 58°.
This was a classic tricuspid valve case with mild calcification distributed along the leaflet edges. Based on the annulus circumference, the TAV27 valve from the VitaFlow Liberty® series was selected. The operator concluded that the straight-frame stent and electric release function of the product would enhance deployment stability, so no pre-dilation was performed, and the valve was released at the standard position.
The final result showed no pressure gradient, no significant PVL, an implantation depth of 1 mm at the non-coronary sinus and 4 mm at the opposite leaflet, and no other complications.
After the procedures, all three Turkish operators highly praised the clinical performance of VitaFlow Liberty®, noting that its delivery system enabled stable and precise valve deployment, while the retrievable function significantly improved procedural success rates. The single-operator design also made the procedures more efficient. They expressed hope for deeper collaboration with Chinese experts to benefit more patients in the future.
As a strategic hub connecting Europe and Asia, Turkey has always been an important partner in the Belt and Road Initiative. This Sino-Turkish medical collaboration not only exemplifies high-level international medical technology exchange but also serves as a vivid practice of the "Health Silk Road", demonstrating the fruitful outcomes of deepened cooperation in healthcare among Belt and Road countries.
Moving forward, the company will seize the opportunities presented by the high-quality development of the Belt and Road Initiative, leverage Turkey’s regional advantages as a bridge between Europe and Asia, and continue to promote the global expansion of innovative medical solutions, enabling more patients to benefit from China’s advancements in medical technology.
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