Healing hearts

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It can be quite daunting finding out that you need heart surgery. But it doesn’t have to be. We met three people who recently underwent a minimally invasive heart valve replacement procedure that changes the lives of previously untreatable cardiac patients.

The ‘three musketeers’, as they are fondly referred to, were Busamed Gateway Private Hospital’s in Umhlanga’s first patients to successfully undergo the TAVI procedure instead of having traditional, invasive open-heart surgery.
The hospital, home to the biggest fully resident cardiac unit in KZN, recently added Transcatheter Aortic Valve Implantation (TAVI) to its growing list of heart procedures on offer.

One of the three, Peter Amm, says it has given him a new lease on life. The Durban-based artist and five-star guesthouse owner is thrilled that he did not have to go through open heart surgery a second time. “I had a triple heart bypass done through open heart surgery. It is a vicious operation – they cut your whole chest open with a saw! The recovery period was long and painful. I insisted on having an alternative to open heart surgery and, luckily, TAVI was an option. Considering my history, it seemed I was a good candidate,” he says.
“This alternative procedure was quite a pleasure. I woke up with no discomfort or pain, and after only two days in ICU, followed by one day in the ward I was able to go home and was up and about within days of the procedure.”

Dr Andrew Asherson, an adult interventional cardiologist, who heads up the TAVI programme, explains that the procedure is used to repair a damaged aortic valve – the main heart valve – which opens and closes allowing blood to flow from the heart to the rest of the body. “Over time, this valve can become thickened and blocked with lumps of calcium. This prevents the valve from opening properly, forcing the heart to work much harder” says Dr Asherson. This condition is called aortic stenosis and may result in symptoms such as breathlessness, chest pain, dizziness, and fluid retention.

“Traditionally, open heart surgery would be necessary to treat such patients. TAVI however, is performed via a small incision in the groin. The replacement heart valve is crimped onto a balloon, like a stent, and is balloon expanded inside the damaged valve, resulting in improved blood flow.”

In South Africa, TAVI is largely performed in older patients who are not eligible for open heart surgery, but Dr Asherson says it is increasingly performed on younger, fittter patients overseas.
“We are at the steep end of our learning curve at Gateway, but worldwide TAVI is increasingly performed in lower risk patients with excellent results. It is as good, and possibly better than open heart surgery in some instances, and represents the future of treatment for the majority of patients with calcific aortic valve stenosis.”

The TAVI procedure is less invasive than open heart surgery, with a much faster recovery period. “The patient would spend probably four hours in theatre and between seven and ten days in hospital with open heart surgery. The TAVI procedure can be done in about an hour under sedation and local anaesthetic, followed by two to three days in hospital.”

Hospital Manager Chris Mbhele says they are privileged to have eight full time cardiologists, including two electrophysiologists and two cardiothoracic surgeons, practising at the hospital, offering several specialized interventional procedures. “We want to thank the TAVI team for their dedication and for working with the hospital to make this important service available to the community we serve,“ he says.
Details: www.busamed.co.za/gateway/

Text and Photo: Elana Wagner

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