Published: Friday, August 12th, 2011
Scottish first for valve surgery
Patient gets a new heart valve through a vein in his leg
In a Scottish first, Cardiologists at the Scottish Adult Congenital Cardiac Service have replaced a patient's heart valve through a vein in his leg – avoiding the need for open heart surgery.
Consultant Cardiologist Niki Walker and Paediatric Consultant Cardiologist Trevor Richens performed the Transcatheter Pulmonary Valve Replacement (TPVR) procedure in a two-hour operation at the Golden Jubilee National Hospital earlier this week (Tuesday 9 August 2011). The pair then went on to perform two more procedures on Wednesday – led by Dr Richens – on teenage patients at The Royal Hospital for Sick Kids at Yorkhill.
The procedure works to replace the pulmonary valve – which allows blood to pass from the heart to the lungs – and is only suitable for patients who have specific congenital heart problems. It is expected that between 10 and 12 patients per year could benefit.
Dr Walker said: "We are delighted that we can now perform this transcatheter technique on patients in Scotland. Replacing the valve in this way is far less invasive and reduces the risks associated with surgery as well as reducing the costs to the NHS by avoiding post-operative intensive care.
"Patients undergoing open heart surgery can stay in hospital for about up to 10 days, but this new technique means they can go home within 24 to 48 hours. We have performed three of these procedures this week and all three patients are recovering well and have now been discharged from hospital. We are absolutely thrilled with the way they have all gone."
How it works
Often, congenital patients will have had at least two previous open heart operations. Unlike open heart surgery, TPVR does not require re-opening the chest wall, which is beneficial for the patient's short term recovery and long term wellbeing.
The procedure is carried out under general anaesthetic in a cardiac catheterisation laboratory (cath lab) – a special type of theatre kitted out with x-ray imaging equipment which can be used to both diagnose and treat blockages in the heart.
The prosthetic valve, made from bovine veins, is specifically designed to fit inside a stent (acting as a scaffold) which is crimped down onto a balloon. This stent is then put into a catheter, which is then inserted to the body through a tiny incision in the leg. A wire has been positioned through the pulmonary valve and is then used to track this catheter through the veins to the heart. When in position, the balloons are inflated, displacing the diseased valve behind the stent and allowing the new valve to function immediately.
The first patient
The first patient to undergo the procedure in Scotland was Ernest (Ernie) Donnelly, who has had two previous open heart surgeries as a result of aortic stenosis, or narrowing of the heart valve.
Ernie, 64, from Greenock, said: "I've had open heart surgery and remember what it was like to be in hospital for so long both before and after my operation. I never expected that I would feel so good after a major procedure like this, but I feel brilliant.
"I was getting out of breath just talking to people but it feels like that has gone away instantly. My daughters came to visit me that night and we were having a good shindig. I'm back at home already; I'm elated with the way it has turned out.
"It's exciting that I'm the first person to have had this carried out in Scotland, but that's all down to Dr Walker and her team. They have been tremendous and I can't thank them enough for what they've done for me."
Date of release: Friday 12 August 2011
Notes to editors:
The procedure was developed by Professor Philipp Bonhoeffer at Great Ormond Street Hospital in London.The stent used is the Melody Transcatheter Pulmonary Valve and is manufactured by Medtronic, one of the world leaders in medical technology and pioneering therapies. For more information about the company, visit www.medtronic.co.ukVisit our websites: www.nhsgoldenjubilee.co.uk
For more information contact:
Golden Jubilee National Hospital
Tel: 0141 951 5073/5195/5175
Mobile/out of hours: Call switchboard on 0141 951 5000 and ask for 'On Call Communications'