What was once a long, invasive operation with slow recovery times has become faster, simpler and cheaper thanks to the introduction of a state-of-the-art procedure at Life St George’s Hospital in Gqeberha — a first for the Eastern Cape.
And the crack team of doctors has already successfully applied the procedure to three patients.
Dr Warren Muller makes a single puncture in the patient’s left groin and then, using a video screen like a computer game, he slides a specialised wire up into the chest area to the problematic aortic valve, the spigot between the lower left chamber of the heart and the aorta.
This is the body’s main artery.
An accumulation of calcium “cement” has narrowed the aorta and the valve is no longer opening fully, reducing the flow of blood from the heart to the rest of the patient’s body, leaving her with chest pain, shortness of breath and a rapid, fluttery heartbeat.
The faulty spigot must be replaced.
The state-of-the-art transcatheter aortic valve implantation (Tavi) was successfully performed at St George’s Hospital for the first time on Friday.
Guided by the wire, Muller and his team slip in a 4.5mm sheath and, through it, they push the replacement valve, a tiny bunched-up filament of tissue.
Then, using a special “delivery system”, like a bicycle pump, they inch the filament out the top of the sheath until it balloons precisely into position.
Born and bred in Nelson Mandela Bay, Muller, 36, was part of the ace Tavi team at Tygerberg Hospital in Cape Town and has returned to his hometown to head up the new team here.
He said on Monday they had already successfully applied the procedure to three patients.
“We operated on all of them on Friday and they are already back home.
“They were all successful operations, which is in line with the 98% success rate overall recorded for Tavi, so I’m very pleased and excited.”
He said his team was particularly happy with one patient who had suffered multiple organ failure and just a few days earlier had experienced cardiac arrest.
“It was an urgent situation as she needed a replacement valve but because of her overall condition, she was not a candidate for open heart surgery.
“We got approval from her medical aid and went ahead, and almost straight away her kidneys started working and she is 100% better than she was.”
He said until now, because of limited specialist procedures being available and challenges with travelling, the outcome of cardiac issues was often poor.
“I’m really looking forward to making sure the people of this province get the same service in this regard as Cape Town and Johannesburg where it is already in place.”
He said the big difference between Tavi and the traditional aortic valve replacement operation was that the patient’s chest no longer had to be cut open.
“The old method takes about four hours while Tavi takes about 45 minutes.
“With the old method, the patient must stay in hospital for two weeks and then it’s another six weeks’ recovery at home.
“With Tavi it’s two days in hospital, and as soon as you’re home you can go back to your normal activities.
“Because of this much shorter time in hospital, Tavi is also cheaper than the traditional procedure.”
He said suitable Tavi patients were patients over 65, who were not suitable for open heart surgery and were suffering from a calcified aorta.
“Younger patients typically do not have the calcification needed to allow the tissue replacement valve to set properly in place and they would need the mechanical valve that can be inserted during open heart surgery.”
A leading “interventional cardiologist”, Muller will head up the St George’s Tavi team with assistance from the hospital’s top cardiologists.
HeraldLIVE
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.