MUSCAT -- The Heart Team consisting of cardiologists and cardiac surgeons and cardiac anaesthetists at Sultan Qaboos University Hospital successfully carried out an advanced procedure for aortic valve replacement on four patients aged over 75 years. The procedure called Trans Catheter Aortic Valve Replacement/Implantation (TAVI) is a minimally invasive approach to implanting an artificial heart valve inside a constricted aortic valve. This approach is for patients who are too high risk for conventional aortic valve replacement surgery. This is for the first time in any hospital in the Sultanate that this heart valve replacement procedure is done. Dr Ali bin Saud al Bimani, Vice-Chancellor of SQU, visited the four patients who underwent TAVI at SQU Hospital the other day.
Dr Hilal al Sabti, Cardiac Surgeon and Deputy Director-General of SQU Hospital for Clinical Affairs and the team leader of the heart team, said that during the valve replacement procedure, the physician inserts the catheter (a tube) through an artery in the groin (Trans femoral approach) or a small incision between the ribs (Trans apical approach). "The artificial valve is compressed and fed through the catheter until it reaches the aortic valve. A balloon expands the artificial valve within the patient's diseased aortic valve and the catheter is removed. The new valve replaces the old, increasing blood flow throughout the body. Trans catheter techniques allow our team to perform the valve replacement procedure while the patient's heart is still beating, eliminating the need for a "bypass" machine and its associated risks", he explained.
Dr Adil al Kindi, Cardiac Surgeon at SQU Hospital, said in the conventional procedure, or the open heart surgery requires stopping the heart and putting the patient on heart lung machine until the replacement is done. "The incision is also quite large down the centre of the sternum. Usually conventional open heart surgery is not advisable among patients who have high risk due to old age and other factors. TAVI involves only catheter based procedure with the help of fluoroscopy to avoid large incisions", he said. Dr Mohamed al Mukhani, Senior Consultant Cardiologist at Royal Hospital, who is also a member of the team of physicians that performed the procedure at SQUH said that even though TAVI is becoming a common procedure in cardiology worldwide, it makes up only a small percentage of the total aortic valve replacement procedures. In minimally invasive cardiac surgery, including TAVI, the hospital stay is very limited. In most cases the patients are discharged on the same day of surgery", he said.
Dr Adil Barakat al Riyami, Consultant Cardiologist, said: "If we were to send these patients aboard for this procedure, the cost will be very high.
© Oman Daily Observer 2013
