Heart valves replaced by keyhole surgery for first time in the UK

Doctors are testing a procedure for replacing the aortic valve without the need for open heart surgery, which involves a large incision down the centre of the chest and opening up the ribcage.

The British Heart Foundation said that a less invasive procedure would particularly benefit frail patients, as well as young children and babies.

Most patients needing aortic valve replacements are elderly people who suffer from breathing problems, making open heart surgery a high-risk option.

But King's College Hospital in London will announce today that two of its patients were the first in Britain to receive new valves using the keyhole technique.

Both suffered from aortic stenosis, which is caused by the narrowing of a valve in the main artery which allows blood out of the heart.

The condition means the heart has to work harder to pump blood around the body.

It causes include an age-related calcium build-up, which can make the valve stiffer, or a congenital deformity.

Symptoms include faintness and chest pain - and in extreme cases the condition can lead to heart failure.

More than 18,000 aortic valves were replaced in the UK last year, but the surgeons hope another 4,000 to 5,000 patients a year could benefit from the new techniques.

In the "transapical" procedure, surgeons make a small incision in the patient's chest and a compressed replacement valve is inserted using a thin tube.

A balloon is put in to push the old valve's tissue flaps against the wall of the aorta - the largest artery in the human body. When the balloon is removed, the new valve begins to work immediately.

The team at King's last month successfully performed another type of keyhole surgery on two different patients. This involved implanting a replacement valve through an artery in the leg.

Olaf Wendler, clinical director for cardiology at the teaching hospital, said: "We are very excited by the results of these operations.

"All four patients were chosen for these procedures because they were considered 'high risk' for open heart surgery.

"Thanks to these techniques, none of the four needed to be admitted to an intensive care unit after surgery. They all recovered without complications and were ready to be discharged home only a week after surgery.

"These new minimally-invasive procedures could potentially revolutionise treatment for patients who suffer from this condition."

Traditionally, open heart surgery involves using a heart-lung machine - but the new procedures sweep away this requirement.

Ellen Mason, of the British Heart Foundation, said: "We welcome this exciting clinical trial where surgeons have successfully replaced heart valves using keyhole surgery for the first time in the UK.

"We hope the findings will lead to these treatments becoming better established and widely available in the future for many more heart patients."

In January 89-year- old Gladys Adams became the first Briton to receive an aortic valve replacement through the leg. Surgeons at the Glenfield Hospital in Leicester operated for an hour on the pensioner.

She was sent home in just two days - compared with the stay of several weeks she would have endured if she had undergone open heart surgery.

Keyhole surgery on a different heart valve, the pulmonary, was first carried out in 2002.

The latest trial is being run with Edwards Lifesciences, a heart valve manufacturer.