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Inflatable valve that can save patients too ill for heart surgery

Anna Davis
11.02.09

Patients who are too ill to have open heart surgery are being offered a potentially life-saving alternative.

The new procedure offers hope for patients in London suffering from aortic stenosis - a condition where a heart valve narrows, causing pain, dizziness and ultimately heart failure.

Most patients undergo open heart surgery to replace the valve, but surgeons will not operate on those who have suffered a stroke or lung disease because it is too dangerous.

But now doctors can insert an artificial valve through an incision in the groin, instead of cutting open the patient's chest and putting the patient's heart on bypass.

Instead of removing the old valve, the new "collapsed" valve is passed along a blood vessel, put into position and then inflated, which crushes the old valve against the wall of the aorta.

Edward Clare, 81, of Kings Langley, Hertfordshire, underwent the surgery last month at St Mary's Hospital in Paddington.

He said: "Before the operation I was totally breathless and was a walking zombie. I couldn't do anything of a strenuous nature - so DIY and gardening was not on the cards.

"Now, one month on, I feel marvellous. I am about 60 per cent recovered and when the weather changes I will be up and running. My aim is to play golf again."

Mr Clare had the new operation because he had already undergone conventional open heart surgery.

He added: "I had my first operation in 1990 and it took me three months to recover because I caught an infection. It also left me with big scars."

Dr Ghana Mikhail, consultant cardiologist at Imperial College Healthcare NHS Trust, which includes St Mary's, said: "This operation is for patients who are deemed too high risk for a traditional operation.

"If they don't get treatment they do badly. This is giving them hope. We want patients and doctors to be aware this is an option because there is a danger that patients could be just written off.

"After this surgery people report feeling less breathless and having more energy and their quality of life improves. It gives people a better standard of living.

"We don't know if it will cure someone but it is an option for people who can have no other treatment and whose prognosis is poor."

Imperial College Healthcare NHS Trust started carrying out the new operation in October, and doctors there aim to complete about 50 a year.

Four other London hospitals - King's, St Thomas', the Royal Brompton and London Chest Hospital - also now offer the operation.

Dr Mikhail said more research needs to be done on the benefits of the operation before it is offered to all patients.

She added: "As this new technology develops we hope to be able to offer this procedure not only to older and higher risk patients, but also to a wider group of lower risk patients."

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