Novel heart valve technique delivers fantastic results

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More patients can now have a heart valve fitted while they are awake thanks to experts at South Tees Hospitals NHS Foundation Trust.

Patient Robert Padget

Patient Robert Padget with TAVI specialist nurse Gemma McCalmont

TAVI – or transcatheter aortic valve implantation – is a non-surgical alternative to open heart surgery which uses advanced imaging technology and a catheter (thin tube) to insert an artificial heart valve.

For most patients the catheter is inserted through a small cut in their groin, but if their arteries are too small for this to work a surgical cut usually has to be made in the chest instead under general anaesthetic.

But cardiologists at South Tees have now developed a novel way of implanting the valves while patients are still awake using an alternative access point.

The TAVI valve is implanted via the axillary artery (a large blood vessel), using a tiny 0.5cm incision just under the left collarbone, which barely leaves a scar. This can be carried out using local anaesthetic so patients are awake throughout the procedure. This is particularly beneficial for older or very frail patients.

As no surgery or general anaesthetic is required, the risk of complications is greatly reduced and less recovery time is required. Most patients are up and about within two hours of the procedure and able to go home the next day.

One of the first patients to undergo the procedure was Robert Padget, 76, of Stokesley who was admitted to The James Cook University Hospital by his GP, after suffering from a heart murmur and breathlessness, where he discovered he urgently needed a new heart valve.

“The staff were absolutely first class,” he said. “I only got odd glances of what they were doing but they explained everything to me. I was home the next day and within three days I realised I was not getting breathless anymore. I only have a tiny scar which will disappear eventually. I was very impressed.”

Cardiologist Paul Williams said: “We are fairly certain these are the first cases to be performed in the UK and this technique offers an excellent alternative treatment for patients who cannot undergo a TAVI procedure from the groin artery.”

Cardiologist Douglas Muir added: “It makes it more challenging for us, but the first cases have gone fantastically well.”