Kiwi surgeons develop life- saving heart technique

Waikato Hospital specialists have pioneered a new technique to treat one of the most prevalent heart valve diseases in the Western World.

Aortic regurgitation is a condition where the heart’s main outflow valve fails to close properly. This causes the blood already pumped out of the heart to leak back in.

Waikato cardiologist Sanjeevan Pasupati and cardiothoracic surgeon Adam El Gamel have devel- oped a technique to successfully treat patients with the condition.

Mr El Gamel said that as the heart stretched to accommodate the extra blood that had to be pumped, it became strained, leaving patients breathless and at risk of heart failure. ‘‘ Traditionally, replacement of the aortic valve has required open heart surgery,’’ he said. ‘‘ However, 10 to 15 per cent of patients who need surgery for aortic regurgitation have other conditions that make it dangerous for them dergo open heart surgery.’’

Now surgeons are applying the Edwards HELIO system technique, involving a cardiologist working from the leg and a cardiac surgeon working simultaneously through a small incision on the chest.

Dr Pasupati said the pair worked together to insert an anchoring device [ dock] from the leg, to place it outside the patient’s aortic valve. A new valve is passed through the

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un- chest and the tip of the heart and placed inside the docking device.

‘‘ The whole apparatus is held in place by the old aortic valve, which is sandwiched between the docking device and the new valve,’’ he said. ‘‘ This procedure corrects the leak and acts as an alternative to major heart surgery.’’

Dr Pasupati and Mr El Gamel, who are both involved in teaching the use of transcatheter implantation techniques worldwide, worked with Edwards Life Sciences to develop the Edwards HELIO system programme.

Four patients have been treated using this approach in New Zealand.

The treatment is an extension of another technique pioneered for New Zealand at Waikato Hospital in 2008, called transcatheter aortic valve implantation. This is used to treat a narrowed aortic valve [ aortic stenosis], and involves a new valve being passed up from the leg, arm, or through the chest.

Waikato DHB internal medicine leader Clyde Wade said the technology was the culmination of a 30- year journey. ‘‘ We’ve gone from a cardiological backwater in Hamilton to now being internationally recognised.’’ Dr Wade said it wouldn’t have happened without the support of the Waikato Heart Trust, the National Heart Foundation and Waikato DHB.

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