A surgical team at Royal Brompton Hospital successfully completed five ‘beating heart’ mitral valve repair operations last week, using a pioneering treatment not offered anywhere else in England, Scotland or Wales.
The ‘NeoChord’ procedure means surgeons can repair a leaking mitral valve on a patient’s beating heart, avoiding the need for them to be put on a heart-lung bypass machine. This means the procedure is suitable for patients with a high risk of developing complications, or who are too unwell to have their heart stopped and re-started with cardiopulmonary bypass.
The five patients were aged between 50 and 80, and included people with previous heart surgery, severely impaired lung function and / or severe calcification in the heart, where calcium deposits form around valves and arteries.
The NeoChord device is inserted into the heart through a small cut in the left chest and navigated to the leaking part of the mitral valve using continuous real-time trans-esophageal echocardiography (TOE).
Four or five artificial ‘chords’ are implanted to repair the valve but, unlike conventional surgery, the length of the chords can be determined on the beating heart at that exact moment.
Ms Rashmi Yadav, the consultant cardiac surgeon who led the team performing the procedures, said: “Patients are generally extubated within three hours following surgery and can expect to go home within three to four days. As the procedure is significantly less invasive than conventional surgery, it offers a new treatment option to patients who may otherwise be denied surgery or who risk complications from the procedure.
“Planning and team work are imperative for the success of these innovative procedures and the input of dedicated surgical, anaesthetic and operating theatre colleagues is absolutely critical, especially when working on new techniques. I feel extremely fortunate to have such a committed and talented team here at Royal Brompton.”
Overall, 17 patients have been treated with NeoChord at Royal Brompton and the team have welcomed visiting cardiac surgeons and cardiologists from other centres such as University Hospital Galway, Ireland, and King’s College Hospital, London.
Dr Alison Duncan, associate specialist in cardiology, provided TOE for the NeoChord procedures. Dr Duncan added: “The success of the procedure is entirely dependent on a ‘Heart Team’ approach, with clear communication, understanding, and trust between the surgeon and imaging cardiologist in order to be able to direct the NeoChords safely to the desired position”.
To find out more about the Trust’s heart services, visit this section of our website.