Take heart – St Augustine’s Hospital can help

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THE replacement of diseased heart valves with artificial ones by means of open-heart surgery is fairly common practice at certain hospitals in KwaZulu-Natal. What is not commonly known though, is that a minimally invasive valve replacement procedure is performed at a local hospital for patients who are not strong and healthy enough to undergo major open-heart surgery.

This was pointed out by Dr Myenderan Odayan, a cardiothoracic surgeon who practises at Netcare St Augustine’s Hospital in Durban. According to Dr Odayan, the intricate Transcatheter Aortic Valve Intervention, or Tavi, is much less invasive than open-heart surgery and is only performed on patients whose health is compromised to the extent that they may not survive conventional surgery.

“These patients tend to be frail and/or elderly, or people with other medical conditions that severely weaken their constitution, and would be considered at high risk of not surviving the anaesthetic for the open-heart operation, or the surgery itself,” says Dr Odayan, who notes that Netcare St Augustine’s Hospital is the only facility in KwaZulu-Natal and one of only five in the country to offer the procedure.

“For these individuals, Tavi is considered the only safe and viable means of replacing their diseased and dysfunctional heart valves. The treatment usually not only extends patients’ lives for many years but also considerably improves their quality of life.”

Offered locally

“While this highly specialised treatment has been offered through a dedicated private Tavi centre at Netcare St Augustine’s Hospital for almost a decade, some of these vulnerable patients are being referred to other provinces for treatment. This is largely due to a lack of awareness that they can have the same treatment locally.

“It is not ideal for these compromised patients to travel long distances to access treatment,” observes Dr Odayan.

Dr Jaivadan Patel, an interventional cardiologist who practises at Netcare St Augustine’s Hospital and who also forms part of the Tavi team there, explains that the procedure is undertaken percutaneously, or in other words, through small puncture holes in the skin. “The transcatheter heart valve is put in place via a catheter and a ‘balloon’ is used to blow up the artificial valve to the correct size. Once the new valve is secured, the balloon is removed,” he states.

Quicker recovery

“Patients usually recover much more quickly from this procedure, are up and about within days of the operation, and are discharged sooner, which is a benefit they appreciate,” notes Dr Patel. The first Tavi procedures in South Africa were completed in 2009, with the support of Netcare, as part of a training programme undertaken to introduce the treatment to the country. These procedures were completed in Durban, Johannesburg and Cape Town under the guidance of renowned international cardiologists and surgeons.

The team at Netcare St Augustine’s Hospital was led by Dr Patel, who was supported by the interventional cardiologist, Dr Mohamed Hassim, cardiothoracic surgeons, Dr Odayan and Dr David Shama, and echocardiographer, Mr Reventheran Pillay. They all underwent training in Switzerland and locally, and form the basis of the highly experienced Tavi team at the hospital today.

Previously untreatable

“The introduction of Tavi was a watershed in the history of local heart medicine and for the first time brought hope to patients who were previously considered untreatable,” notes Netcare St Augustine’s Hospital general manager, Heinrich Venter. “We are proud to offer this highly specialised service, which has already saved numerous lives over the years since its introduction. The hospital would like to thank the entire Tavi team for their dedication and for working with the hospital to make this important service available to the community we serve,” concludes Venter.

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