A rare cardiac procedure was conducted on an elderly UAE national by doctors at Sharjah’s Al Qassimi Hospital making it the first hospital in Asia to have successfully completed the surgery.
Dr. Arif Al Nooryani, a UAE national interventional cardiologist, along with two internationally renowned heart specialists conducted the first transcatheter aortic valve implantation (TAVI/ TAVR) on Sunday.
Preparations for the procedure on the 88-year-old citizen were held locally and performed by a team of ten professionals, headed by three specialized interventionalists, anesthetists and nurses from the cardiac team.
TAVI is known as a rare operation method, which is risky and costly. This type of procedure is preferred for patients whom surgeons consider not suitable for conventional surgery. Patients are commonly affected by severe symptomatic aortic stenosis (narrowing of the aortic valve opening), who are not eligible for traditional open chest surgery or inoperable candidates. TAVI is performed on a beating heart and does not require cardiopulmonary bypass (a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body).
The patient had a symptomatic history and was diagnosed with heart failure. The cost of a TAVI surgery in the UAE is about Dh220,000 and in the case of the UAE national it is paid by the government.
A two centimeter cut at the front neck will be opened and a wire crosses through the artery to the heart. A catheter about the size of a pen is carefully passed up to the heart to check its pressure and conditions prior to inserting the valve. In the meantime the valve (made of bovine (cow) tissue and supported on a metal stent and preserved in a small box) is prepared for approximately 15-20 minutes in cold/icy water.
When the valve is ready for use, the surgeon inserts it into the wire and squeezes the valve through to the heart and deploys it inside the narrowed valve in the heart resulting in a normal functioning aortic valve.
The patient stays in the hospital for up to four days for observation and is asked to visit the doctor for regular check-ups on a frequency of every three month.
As of today, 60,000 valves have been implanted worldwide and numbers are increasing due to its convenient and comparatively secure method. Al Qassimi Hospital is furthermore the only certified center in the UAE for implementation of a device called watchman (a filter-like device, which looks like a jellyfish, protects sufferers from harmful blood clots, is used to protect from stroke). The hospital reports state 113 cases of TAVI completed with success and receives currently one to two requests per month.
Dr. Arif Al Nooryani is certified to perform this kind of intervention independently and is authorized in the learning program mentoring new medical professionals for those new surgical procedures.
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