New technique gives fresh lease of life to heart patients

By Noimot OlayiwolaStaff Reporter

Dr al-Khulaifi (second left) explains a point as Dr al-Nabti, Dr Jarvis and HMC Corporate Communication department representative look on

The Hamad Medical Corporation’s Heart Hospital has successfully used an innovative technology to treat patients suffering from aortic stenosis - a disease of the heart valves in which the opening of the aortic valve is narrowed.A team of specialists from the Heart Hospital, including technicians and anaesthetists, on October 15 performed two different surgeries making use of the new Transcatheter Aoritc Valve Implantation System (TAVI) technique to replace the cardiac valve in two patients, a 75-year-old Qatari woman and a 61-year-old Pakistani male.Both patients are recovering well and will be able to return to normal life, doctors said.The surgical team included Valve Transplantation Programme head Dr Abdulrahman al-Nabti and Cardiothoracic Surgery chairman Dr Abdulaziz al-Khulaifi.“Both patients have suffered aortic stenosis and they both also have multi-organ failure and they had limited ability to withstand normal open heart surgery, which is still the gold standard,” Dr al-Nabti said at a press conference yesterday.Previously, patients in Qatar in need of TAVI had to travel abroad for the surgery using the new technique that allows for a replacement valve to be delivered via a catheter using one of several access methods: transfemoral (in the upper leg), transapical (through the wall of the heart), subclavian (beneath the collar bone) and direct aortic (through a minimally invasive surgical incision into the aorta).Globally, more than 50,000 TAVI procedures have been performed.Currently, around 10 patients have been screened and identified for the procedure.“TAVI, whose single unit cost QR140,000, has tremendous advantage over the open heart surgery because the procedure lasts only two-three hours and the length of hospital stay is usually not beyond three days,” al-Nabti said.He explained that TAVI is an artificial aortic heart valve attached to a wire frame, guided by catheter (thin, flexible tube) to the heart and once it is in the proper position in the heart, the wire frame expands, allowing the new aortic valve to open and begin to pump blood.The human heart beats more than two billion times. With each beat, flexible valves within the heart’s chambers open and shut to prevent blood flowing backwards and with advancing age these valves can start to fail; the opening can become narrowed which reduces blood being pumped to the heart, resulting in dizziness, difficulty in walking and other complications. This condition is also known as angina, one of the most common forms of heart diseases and if left untreated can often be fatal.“Patients who undergo the procedure must pass a rigorous screening, then the preparation process to ensure they are ready for the operation. The pre-surgery tests can take up to one month to perform and involves a team of up to 20 people including surgeons, clinicians and other support staff,” said Dr al-Nabti, who has trained in Canada in the procedure which addresses one of the most common causes of heart disease.Manufacturers of the valve also work with teams from the Heart Hospital to ensure they are up to date with advances in the procedure, he said.“This is an extremely effective treatment option for many of our patients and enables them to regain quality of life. We are now able to offer this life changing procedure here in Qatar, performed by our highly trained surgical teams at the Heart Hospital,” Dr al-Khulaifi said.According to Dr al-Nabti, the success rate of the technique is up to 98%, however, he said some patients may develop complications ranging from injured artery to slowing of the heart, slow heart rate, leaking heart and some of the patients may require a pacemaker after the surgery.Also speaking about the procedure, the Heart Hospital acting chief executive officer Dr Lionel Jarvis said the technique is a well established procedure in international practice, which has been used to treat tens of thousands of patients around the world, adding that the hospital has the potential to be a leading facility in the Middle East.