EXCLUSIVE
Medical experts at St Vincent’s Hospital implant artificial valves while the patient’s heart keeps beating. Photo: Peter Rae
Sydney doctors have repaired leaking valves on two hearts that were still beating in a pioneering procedure that will save the lives of people at risk of heart failure.
Rather than stopping the hearts and using a bypass while the valves were repaired, doctors implanted artificial valves inside the old leaky ones while the hearts continued to drum.
Each patient suffered from mitral valve regurgitation, a common condition whereby the valve between the left ventricle and left atrium does not close properly so the blood runs back into the lungs instead of going to the aorta.
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Team replaces valve on beating heart
Sydney doctors have repaired leaking valves on two hearts. Photo: Peter Rae
Surgeon Paul Jansz said the procedure would improve the quality of life of people who were not good candidates for surgery and buy them more time before their hearts gave out.
“The significant thing is that we don’t have to stop the heart, so we don’t have to put the patient through all the extra rigors of heart surgery,” Dr Jansz said.
The first patient was operated at St Vincent’s Hospital in late November, and after six weeks without complications doctors performed the procedure on another patient on Wednesday.
Sixteen people filled the operating theatre for the second procedure on Wednesday, including surgeons, echocardiographers, anaesthetists, nurses and the industry engineers who designed the device.
Dr Jansz made an incision through the ribs, and head of interventional cardiology David Muller implanted the device that would act as a new valve, guided by anaesthetist Marty Shaw.
Shaped like a flower, the device consists of an artificial valve fashioned from the heart tissue of a pig, which is sewn into a metal cage and tethered to the apex of the heart with string.
As they moved it into position, the team’s patter resembled boatmen easing a craft into the water: “We need to come in a bit more centrally” – “That’s better” – “Little more away, little more in the same direction” – “Clockwise” – “One more little squeeze” – “Big squeeze” – “I’m not going to do any more. I think the orientation looks good.”
Dr Muller said doctors had been able to replace aortic valves for seven or eight years, because they became calcified so a new structure could be easily wedged inside.
“But the mitral apparatus is much more elastic and it changes its diameter with each contraction, so to have something sit there it would fall out without having something there to hold it,” Dr Muller said.
“The unique part of this device is that it’s tethered to the apex of the heart.”
It was also easily removable.
“So there should be no downside to putting it in and trying it. It’s a much less invasive, much better tolerated procedure for patients who are not well.”
Patient Michael Dwyer, 73, was groggy in the aftermath of his operation, but recovering well and expected to be discharged from hospital within days.
His wife, Cheryl, said the procedure had saved his life, after he suffered major organ failure in December.
“He was slowly dying,” Mrs Dwyer said.
“Having this procedure, which is a groundbreaking, revolutionary surgery, it’s a miracle really.”