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Times of India
29 March 2011
London, UK

Method Brings Hope To Those Too Sick For Open–Heart Surgery
A team in Britain, led by an Indian–origin surgeon, has come up with a one–hour keyhole operation to replace heart valves, a breakthrough which offers hope to cardiac patients too sick to undergo an open–heart surgery.

Vinayak Bapat of Guy’s and St Thomas’ Hospital and his team have developed the procedure, called transcatheter aortic valve implantation (TAVI), which treats heartvalve failure under local anaesthetic without the need for a bypass surgery. "For seriously ill patients who do not have the option of heart surgery, TAVI is their one chance of life. It has the potential to save thousands of lives and is ultimately cheaper than prescribing years of medication," Dr Bapat said.

Aortic stenosis is the most common type of valve disease which can be caused by birth defects though in older patients it is usually the result of calcium building up in the heart’s main valve, the aortic valve, hindering blood flow. The best solution is valve–replacement surgery via open–heart surgery, which involves opening up the patient’s chest, putting their heart on a bypass machine and replacing the aortic valve.

But the TAVI requires only a small incision made in the thigh or chest to insert a stainless steel mesh tube with heart tissue from a cow lining the inside of it, say surgeons.

The tissue is derived from the tough sac surrounding a cow’s heart or pericardium. It is recovered during commercial meat processing after which the membrane is slightly stiffened with a tanning solution. During the operation a hollow tube, or catheter, is inserted into the body. On the end of the catheter is a deflated balloon as well as the collapsible artificial valve.

When the catheter reaches the faulty valve, the balloon is inflated which, in turn, expands the mesh valve, crushing the broken human valve against the wall of the aorta, say the British surgeons.

TAVI requires just six days in hospital compared with ten for open–heart surgery, and some patients have been discharged after four days.

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