10 happy hearts

A group of very special patients were invited back to Spire St Anthony’s Hospital to celebrate their surgery. Each had undergone a Transcatheter Aortic Valve Implantation (TAVI), a procedure that has revolutionised the treatment of aortic valve disease, the commonest serious heart valve condition treated these days.

Formerly, a large proportion of older patients were considered inoperable and too high risk or frail to undergo open heart surgery and were left untreated with a very poor outcome and quality of life. The TAVI is a minimally invasive procedure, which means it is carried out using only keyhole surgery.

Spire St Anthony’s Hospital is not just the first Spire Healthcare hospital to offer this treatment but it is one of very few private hospitals in the UK with the facilities and skilled staff able to treat patients with severe aortic valve stenosis.

The former patients were invited for tea and joined by the team who cared for them and consultant cardiologist Dr Sam Firoozi, the surgeon in charge of the teams performing the TAVI at Spire St Anthony’s Hospital.

Dr Sam Firoozi explains why this landmark is so important:

“Severe aortic valve stenosis is a common cardiac condition affecting mainly older patients and if left untreated has a high mortality rate and majorly impacts a patient’s quality of life. Whilst open heart surgery is one way of treating such cases, TAVI is used as an alternative to open heart valve replacement and offers patients a faster recovery and better outcome compared to conventional open surgery. It is now a well-established procedure at Spire St Anthony’s and carried out by multiple consultants with proven, excellent outcomes for our patients.”

As one patient explained:

“I’ve found life extremely good since I had my operation. I had the procedure on the Saturday and was back at home playing bridge by Wednesday. My wife didn’t even change our plans for the following weekend. We just carried on as normal.”

The procedure

TAVI involves the patient being fitted with a new heart valve by passing the valve through an artery in their groin or chest to the heart. The small incision and minimally invasive technique dramatically cuts down the length of recovery time.

 Hospital Director, Mr Bryan Harty explains:

“TAVI allows patients who were formally considered too sick to undergo surgery a treatment that can make a dramatic difference to their quality of life.  This innovative procedure is typical of what is available at this hospital. Our teams want to be able to offer patients the very latest treatments. Dr Firoozi and his team are an example of making exactly that happen.”

The new hybrid operating theatre at Spire St Anthony’s Hospital enables teams of surgeons to carry out more complex procedures than ever before. The hybrid theatre has built‐in radiological screening capabilities delivering live images on multiple monitors around the room for the surgeons to view whilst carrying out complicated, minimally invasive procedures.

Mr John Yap, cardiothoracic surgeon and Mr Mike Mullen started the procedure at Spire St Anthony’s Hospital in January 2017. Since then many patients have been treated with TAVI. Today the hospital has multiple consultants using the technique and more than 40 cardiac specialists. The team includes consultant interventional cardiologists, non-invasive cardiologists, electrophysiologists, specialist consultant anaesthetists, ITU physicians, nurses, cardiac physiologists and support staff.

Transcatheter Aortic Valve Implantation (TAVI)

A heart has four valves responsible for pumping blood around the body. If the aortic valve fails to open properly it can obstruct blood flow out of the heart. Adults may require an aortic valve replacement and be suitable for the non-surgical TAVI procedure.

• The procedure can be performed under general or local anaesthetic.  A catheter (a hollow tube) is inserted into an artery either in the groin or under the collarbone.
  
  
• The catheter is passed up through the aorta and into the heart, and is positioned within the opening of the aortic valve.
  
  
• The valve is then carefully positioned and released over the existing native valve and this squashes the narrowed valve, to make room for the new valve.
  
  
• The new valve then either expands by itself or is expanded using the balloon, depending on which type of valve is used.
  
  
• The new valve once deployed starts to work immediately and the heart function improves with the new valve in place.
  
  
• Most patients are out of bed the morning after the procedure and our aim is for them to be discharged 48-72 hours post procedure.

Another way to perform this procedure is to make a cut between two of your ribs and insert a catheter directly into your left ventricle or aorta and across the narrowed valve. This is called a transapical or transaortic approach. 

To learn more about the cardiac services at Spire St Anthony’s call: 020 8335 4646.