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Fancy having heart surgery one day, then being up and walking the next?
This was the case for 83-year-old Colin Davey, who was the first patient at Wellington Hospital to undergo an aortic valve transplant using a catheter through the groin.
The Marton resident had surgery to fix his faulty heart valve last Thursday morning, and was on his feet the next day, carefully, and home by Sunday.
‘‘It’s quite amazing, really. I did have concerns when I was told I was the first to have this new operation and thought, ‘Goodness me, I’m the first one up’.’’
The procedure – officially known as transcatheter aortic valve implantation (TAVI) – is a minimallyinvasive procedure that allows cardiologists to replace the aortic valve without the need for open heart surgery.
Professor Alexander Sasse, lead cardiologist at Wellington Hospital, said the secret lies in a pig’s valve attached to a piece of nitinol mesh – a lightweight metal that can flex and contract while retaining its original shape.
The valve itself resembles a piece of fancy pasta, and at a cost of $28,000 a piece it’s certainly a delicacy.
Using a catheter, the implant is inserted into the aorta during a twohour operation that leaves very little, if any, scarring and massively cuts down recovery time.
Overall, it is a much less invasive alternative to open heart surgery, which traditionally means cutting through bones in the chest.
‘‘To think they went into the thigh and put it right up to my aorta, it’s quite amazing,’’ Davey said.
Sasse said the valve pops into place in the heart, where it immediately gets to work pumping blood. It expands as soon as it hits circulation.
The aortic valve opens up about 100,000 times in all of us every day. That wear and tear is too much for about 5 to 10 per cent of Kiwis, he said.
‘‘The only way you could fix it up until recently was – basically you take a saw and cut through the bone. They came up with this idea of putting a valve in a catheter.’’
Last year, Sasse and Dr Phil Matsis travelled to several overseas hospitals that were already performing high volumes of these procedures to learn the latest techniques and patient management systems.
There’s even the option of putting a valve within an existing replacement valve, known as ‘‘double-valving’’.
Waikato Hospital was the first to begin using the procedure in this country in 2008. Wellington is now the fifth hospital to offer the catheter option.
The procedure is done under general anaesthetic, but some Australian hospitals are doing them under local anaesthetic, meaning patients are awake while they are having heart surgery.
Matsis, Wellington’s lead operator for TAVI, said patients are usually discharged after 48 hours – some in as little as 36 hours – and can go back to normal life within a week.
Six years worth of data suggests it will be just as durable as a traditional replacement tissue valve.
‘‘It seems to be, the older you are the longer the device lasts,’’ Matsis said.
Each procedure costs about $60,000 – slightly less than the traditional open heart method, which is about $62,000.
The savings come in recovery time. Only 5 per cent of patients end up in ICU after a TAVI treatment, and if they do, it is a brief stay.
Capital and Coast District Health Board has set aside funding for 20 TAVI procedures in the first year, at a gross cost of $1.2 million.
Two patients have been treated so far – Davey and an 85-year-old woman. She was discharged after 72 hours.
High-risk patients, such as the elderly, patients who have already had heart surgery or those who have multiple medical conditions, can be assessed for the procedure.
Davey said the new valve had given him hope for the future.
‘‘You feel a bit confident about your life. You feel good in yourself and that makes all the difference.’’