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Keyhole for old artificial valves Keyhole for old artificial valves
(about 1 hour later)
Doctors in the UK say they have for the first time used keyhole surgery to replace an old prosthetic heart valve.Doctors in the UK say they have for the first time used keyhole surgery to replace an old prosthetic heart valve.
The technique has already provided new valves for those too ill for open heart surgery, but this is the first time a replacement has itself been replaced.The technique has already provided new valves for those too ill for open heart surgery, but this is the first time a replacement has itself been replaced.
The procedure means elderly patients effectively have a second roll of the dice if their replacement valve fails.The procedure means elderly patients effectively have a second roll of the dice if their replacement valve fails.
It was assumed that most would die before needing a new one, but increased life-expectancy has altered that view.It was assumed that most would die before needing a new one, but increased life-expectancy has altered that view.
Doctors at King's College Hospital in London carried out the surgery on a 78-year-old man whose first artificial valve was inserted during open heart surgery in 2002.Doctors at King's College Hospital in London carried out the surgery on a 78-year-old man whose first artificial valve was inserted during open heart surgery in 2002.
This began to fail last year, causing breathlessness and fainting.This began to fail last year, causing breathlessness and fainting.
In and outIn and out
Surgeons said he was too high risk to be put forward for open heart surgery again but that he was suitable for the less invasive procedure, known as transapical aortic valve replacement (TAVI).Surgeons said he was too high risk to be put forward for open heart surgery again but that he was suitable for the less invasive procedure, known as transapical aortic valve replacement (TAVI).
Because patients undergoing repeat operations on the heart are twice as likely to suffer complications following surgery, many are not put forward again Olaf WendlerKing's College Hospital surgeonBecause patients undergoing repeat operations on the heart are twice as likely to suffer complications following surgery, many are not put forward again Olaf WendlerKing's College Hospital surgeon
Keyhole surgery techniques are far more suitable for weaker patients, as they are far quicker, require less anaesthetic, do not leave a large wound and as a result, generally mean shorter recovery times in hospital.Keyhole surgery techniques are far more suitable for weaker patients, as they are far quicker, require less anaesthetic, do not leave a large wound and as a result, generally mean shorter recovery times in hospital.
Some doctors insert a tube carrying the replacement valve into a blood vessel at the groin and push it through. The King's technique passes the valve directly though the chest wall into the bottom of the heart.Some doctors insert a tube carrying the replacement valve into a blood vessel at the groin and push it through. The King's technique passes the valve directly though the chest wall into the bottom of the heart.
It was first carried out successfully in the UK in 2007, and hailed at the time by experts as a major step forward in heart operations.It was first carried out successfully in the UK in 2007, and hailed at the time by experts as a major step forward in heart operations.
Olaf Wendler, the surgeon who carried out this latest operation, said: "We are very excited about what this could mean for patients at King's and other hospitals. Because patients undergoing repeat operations on the heart are twice as likely to suffer complications following surgery, many are not put forward again.Olaf Wendler, the surgeon who carried out this latest operation, said: "We are very excited about what this could mean for patients at King's and other hospitals. Because patients undergoing repeat operations on the heart are twice as likely to suffer complications following surgery, many are not put forward again.
"The fact that the minimally invasive technique developed at King's has now been used successfully to replace a prosthetic heart valve is a major achievement, and could help to prolong and improve the lives of many patients in the UK.""The fact that the minimally invasive technique developed at King's has now been used successfully to replace a prosthetic heart valve is a major achievement, and could help to prolong and improve the lives of many patients in the UK."
British Heart Foundation cardiac nurse Ellen Mason said: "As far as we are aware, this is a groundbreaking UK first. To replace a mechanical heart valve with another one without having to open an elderly patient's chest is a remarkable feat.
"Twenty years ago this concept would have been the cardiac equivalent of landing a probe on Mars - something that could hardly have been envisaged.
"Procedures like this, which don't require open heart surgery, look increasingly likely to be the way of the future. Results of the follow up of patients having these procedures will need to inform future practice, depending on how well their new valves function in the months and years ahead."