St Dom’s joins SA hospitals to offer specialist heart surgery
Aortic valve replacement performed via catheter instead of opening up chest
East London’s Life St Dominic’s Hospital has introduced groundbreaking surgery in its cardiac treatment which until now was only available in the Western Cape and Gauteng.
Two patients have already undergone the surgery, known as transcatheter aortic valve replacement (TAVR), since its inception on January 12 and 13.
Both patients are home and and reportedly doing well.
The hospital said the “less invasive surgical procedure” treated patients with a type of heart valve disease called aortic valve stenosis.
This, they said, negated the need for local patients to travel for this treatment.
Local cardiologist Dr Dave Kettles is part of a team of specialists trained to perform the TAVR procedure to treat patients with severe symptomatic aortic stenosis. They are supported by trained cath lab nursing staff, cardiac technologists and cath lab radiographers.
Kettles said: “Performing this TAVI (transcatheter aortic valve implantation) at Life St Dominic’s Hospital allows us to offer aortic valve replacement to some patients whose risk for traditional valve replacement, by means of open heart surgery, is very high.
“This procedure does not require the chest to be opened, and often allows patients the benefits of a new valve with much more rapid post-procedural recovery and a shorter hospital stay. This procedure has until now only been available in the Western Cape and Johannesburg or Pretoria, so being able to offer this surgery to our patients right on their doorstep does represent a milestone for us.”
Dr Warren Muller, a cardiologist from Life St George’s Hospital in Gqeberha, and experienced TAVI operator Dr Adi Horak from Life Vincent Pallotti Hospital in Cape Town, are also part of the team.
Hospital manager Musa Madonsela said: “Being able to offer TAVI procedures to our Border-Kei community is another step towards the continued provision of comprehensive healthcare to our patients. It is a new therapy locally, that we can now regularly offer in East London.”
There is no waiting list, but multiple steps are required to evaluate a patient and then assemble the team for this procedure.
The hospital said the surgery would be performed on older people as aortic valve narrowing is usually a disease common in the elderly. This procedure is designed to allow valve replacement, particularly in those who are too old for the usual open valve surgery to be performed safely.
For patients to qualify they must have a narrowed aortic valve that causes symptoms, and who are unsuitable for conventional aortic valve surgery.
In patients who qualify for TAVI, aortic valve replacement is performed through the femoral artery in the groin from where the new valve, in a collapsed state, can be inserted via a stiff wire into the correct position at the outlet of the heart, and then deployed into its permanent position. The small hole in the groin is stitched up and usually heals quickly.
Usual symptoms of aortic valve stenosis may include:
• Chest pain (angina) or tightness, with activity;
• Feeling faint or dizzy or fainting, with activity;
• Shortness of breath, especially with activity;
• Fatigue, especially during times of increased activity.
But Kettles said the symptoms were not specific to valvular heart problems, and could also occur in a number of other conditions.
“Individuals should seek medical advice should they be experiencing any of these symptoms or have any concerns about their heart health.”