New way to plug a leak

Life-saving procedure: Dr Azmee (left) and Dr Aizai say that the non-invasive surgery to fix the valve problem could reduce the mortality rate in high risk patients.

KUALA LUMPUR: The National Heart Institute has become Asia’s first hospital to successfully perform a non-invasive surgery to fix a right heart leaky valve or what is medically termed as ‘tricuspid regurgitation’.

The TricValve Transcatheter Bicaval Valves system involves a minimally invasive procedure that places a dry stent valve to fix the problem, similar to how a coronary angiogram is carried out through the right groin.

The inaugural implantation was carried out in May on a 67-year-old woman who had long-term hypertension and atrial fibrillation or irregular heartbeat.

“She was referred to IJN a year ago when she developed symptoms of heart failure and we performed an assessment.

“We were considering surgery although she was deemed as high risk, but the patient was not keen, so we treated her conservatively with medications.

“When this TricValve option came about, we offered it to her and she agreed.

“She’s doing very well and her quality of life has improved as she can do more things and requires fewer medications, which corresponds to some degree of improvement in the right ventricle,” said consultant cardiologist Datuk Dr Azmee Mohd Ghazi at a press conference yesterday.

The heart valves control blood flow through the heart and when there is a leaky valve, it doesn’t close properly, causing some blood to flow backwards.

In tricuspid regurgitation, the valve between the two right heart chambers (right ventricle and right atrium) doesn’t close tightly enough and this malfunction allows blood to flow back into the heart’s upper right chamber.

“In IJN, we see many patients with this disease who have been referred to us for further management.

“Although there is no local data on what percentage of the population is affected, from the literature, we know it occurs in about 65%-85% of the population when they are screened using an echocardiogram,” he said.

In the United States, roughly 1.6 million people suffer from this condition and require treatment.

Patients may experience symptoms such as fatigue, abnormal heart rhythms, shortness of breath, and swelling in the legs and abdomen. However, these signs often do not develop until the condition becomes severe.

Dr Azmee, who is also IJN’s clinical director of heart failure and heart transplant said most patients were treated with medication to reduce the symptoms but not the underlying cause.

“Unfortunately, some patients come at a late stage of the disease and medications don’t work anymore and open heart surgery is not an option for them as they are deemed high risk.

“Now there is an option to reduce the mortality rate,” he added.

IJN’s chief executive officer and senior consultant cardiologist Datuk Dr Aizai Azan Abdul Rahim was delighted with his team’s effort in seeking out newer and more innovative methods of treatment.

“It’s no secret that IJN’s success has been built on the willingness of its staff to keep learning, exploring new innovative treatments that can enhance patients’ quality of life, and pushing the boundaries to be able to treat more patients who are deemed unsuitable for surgeries,” he said.