The heart team at The James Cook University Hospital has reached an exciting milestone after successfully carrying out one of its most advanced procedures on more than 500 patients.
TAVI (transcatheter aortic valve implantation) is an advanced procedure in which a team of specially trained consultants replace a narrowed heart valve without the need for open heart surgery.
In some patients, particularly older patients, this aortic valve narrows down over time and stops the heart pumping as hard as it should do. This often causes breathlessness or chest pain symptoms but it can be improved with open heart surgery or TAVI.
Open heart surgery would involve opening up the patient’s chest, stopping their heart and inserting a new artificial heart valve, which is often too high risk for more frail or elderly patients.
But TAVI gives these people another option as it is much less invasive. TAVI patients are fitted with new heart valves using advanced imaging technology and a tube (catheter) which is inserted through a small cut in their groin or chest so there is no need to stop the heart.
Cardiologists at the Middlesbrough hospital completed their 500th TAVI case in June, but it is a procedure which has advanced rapidly over the years.
When patients first had TAVI in 2009 they would come into hospital the day before, have a general anaesthetic so they would be completely asleep for the procedure and then spend three to five days recovering on the ward.
Eight years on, patients can now attend on the day, most have a local anaesthetic so they are awake throughout the procedure and the equipment used is more sophisticated.
This speeds up recovery and reduces complications – around 60% of TAVI patients now go home the next day.
Consultant cardiologist Douglas Muir said: “The vast majority of patients find this a very tolerable procedure. But most importantly, the patients can get up and walk around a lot quicker, they can go home quicker, and when we see them back for follow up almost all of them have seen some clinical benefit.
“It’s a great honour to be able to treat patients in this way because the procedure makes such a difference to their quality of life and that’s really rewarding.”
One of the earlier patients to undergo the procedure was George Carmichael, a retired marine engineer from Stockton.
When George started to feel breathless he doubted there was much that could be done for him as he had already had open heart surgery in the past, but in 2011 he underwent a TAVI procedure and has never looked back.
George, now 84, said technology seems to be catching up with him as he gets older!
“I hadn’t heard of TAVI before but they said I had the strength to go through the procedure and it was quite amazing really. Within 48 hours I was out of hospital and I just thought that was brilliant.
“There was no pain at all. Whereas when I had open heart surgery there was some discomfort afterwards.
“Mowing the lawn yesterday took me 20 minutes, prior to this it would take me an hour and I would have to stop because I was breathless. I’m just over the moon about the whole thing.
“I’m just full of life because I am having days that are a bonus. Every day is a bonus.”
Bill Jones, 91, had a TAVI operation earlier this year to repair his faulty heart valve. The retired engineer was awake through the whole procedure and back home the next day.
Bill of Yarm, who celebrated his 60th wedding anniversary this year with wife Pamela, said: “I was surprised how smoothly the procedure went. It lasted less than an hour and even though I was awake I wasn’t conscious of anything happening to me.
“After the procedure I felt a little bit shaky for about half an hour, but I then recovered and felt virtually back to normal.
“The first time I went to the shop to get the paper I was surprised how much easier it was. Before I would have got out of breath. In just under a week I felt almost as fit as I was in my fitter days.”
TAVI Specialist Nurse, Gemma McCalmont said: “TAVI is still a relatively new procedure. But for us to now offer it to patients previously considered in-operable, it’s just a really wonderful thing. It’s really exciting that we’ve hit our 500th case!”
Dr Muir added: “We have done increasing numbers year after year, and we can see that over time numbers will continue to increase. As the risk of the procedure goes down we anticipate more patients will be eligible for this treatment.”