ÃÛÌÒAPP
Surgeons at the city’s Freeman Hospital have used a pioneering technique to repair damage to a patient’s heart sustained during a heart attack.
The procedure known as ‘transcatheter ventricular enhancement’ is not yet standard clinical practice, and the Regional Cardiothoracic Centre at the ÃÛÌÒAPP hospital is the first, nationally, to carry it out.
It is hoped the operation, which repairs the heart without having to stop it beating, will help save thousands of patients across the country.
The first operation was performed on Ian Whitehead by heart specialists led by Professor Azfar Zaman and Professor Stephan Schueler – both based at the Freeman Hospital.
Professor Zaman said: “Following a major heart attack, the heart muscle heals by forming a scar. Over time this scar can stretch, which in turn stretches the normal heart muscle. After several years, this stretching of the heart by the scar tissue can lead to heart failure, which in turn can become life-threatening.
“Until now, the only way of removing the scar tissue has been through open heart surgery which many patients with heart failure are simply not well enough to tolerate. If we cannot treat them, the prognosis is not very good.”
Minimally invasive approach
The transcatheter approach is a minimally-invasive procedure which means it does not require the chest to be opened and is carried out by keyhole surgery involving a small cut in the chest wall.
Professor Zaman added: “This new procedure seeks to reduce the size of the scar tissue by literally ‘tying it off’.
“The surgeon makes a small cut in the chest to access the heart and puts in some stitches to pull healthy tissue over the scarring. At the same time, the interventional cardiologist enters the main vein in the neck using a special catheter – an extremely thin tube – to reach the heart. They meet in the middle.
“The cardiologist then picks up the stitching using a special device in the catheter, and pulls it like a purse string, effectively closing the scarred area. The heart is no longer under stress by the scar tissue and can pump blood round the body as normal again.”
Professor Schueler, added: “This approach is a revelation for patients who find themselves debilitated by severe heart failure due to scarring and faced with high risk treatment options.
Because we are not resorting to open heart surgery or operating on the heart itself, we do not need to stop the heart and use cardiopulmonary bypass. The minimally-invasive procedure takes place with a beating heart and so is much safer for the patient.”
UK’s first patient
The first patient to benefit from this revolutionary new approach is Ian Whitehead – a 63 year old grandfather.
Mr Whitehead had a heart attack in 2003 and was successfully treated by thrombolytic – clot busting – therapy and insertion of coronary stents.
After a while the retired civil engineer began to display the classic symptoms of heart failure – breathlessness and fatigue.
He was referred to the regional heart failure service at the Freeman Hospital where he was assessed by the specialist heart failure team and an echocardiogram showed scarring on his heart which was contributing to his dilated heart and worsening his condition.
Mr Whitehead, married to Mary, said: “When I was told I would be suitable for this new procedure I thought ‘why not’. But then as the date of the operation got closer I became a bit more worried.”
The operation, performed just a few weeks ago, took seven hours and Mr Whitehead, a father of three, is now recovering.
He said: “I am getting back on my feet. The doctors have been incredible and I could not have asked for more support. The aim now is to start doing a bit more exercise and being more physical so I can help the heart as much as possible.
“I’m not going to lie and say it has not been difficult, but I feel I’m recovering well and looking forward to the future.”