Groote Schuur is the first SA hospital to perform an open-heart aortic valve replacement operation using a keyhole incision – a procedure set to revolutionise heart surgery.
|||Cape Town - Thousands of public health sector patients in need of open-heart surgery may not have to go the usual route of cutting through the breastbone, but may be able to have keyhole surgery.
Last week, Groote Schuur Hospital became the first hospital in the country to perform an open-heart aortic valve replacement operation using a keyhole incision – a procedure set to revolutionise heart surgery.
Cardio-thoracic surgeon at Groote Schuur, Dr Jacques Scherman, performed the procedure on Boniswa Simon, from Khayelitsha, who had a leaking aortic valve.
The 55-year-old Simon was admitted to Groote Schuur with severe heart failure that was characterised by breathlessness and severe sweating because of the leaking valve. She said not only was she well again and could now “breathe again”, but she had less pain.
“I was very sceptical when the doctor told me I was going to be the first patient to have this procedure because I didn’t want to be guinea pig, but I can’t believe I just had a surgery… The soreness is not bad at all. I can’t imagine what it would be like if they cut through my chest bone. Whatever doctors did, it worked magic,” she said.
Dr Scherman said while minimally-invasive open-heart surgeries were a standard of care in First World countries such as the US and those of Europe – in South Africa this was not widely practised because of a skills shortage.
Scherman specialises in keyhole heart surgery after two years of training at the University Hospital of Zurich in Switzerland. He said this approach to surgery, now used at Groote Schuur Hospital to treat various heart defects, was so successful the hospital was setting up a training programme in the province.
“Essentially in the past three years we’ve used keyhole surgery to repair a number of heart problems, such as congenital heart defects, hole in the heart and heart valve surgery, but it’s the first time we’ve done aortic valve replacement surgery, which is typically an open heart surgery,” he said.
This surgery is conventionally done through a sternotomy or by dividing the breast bone, but when doing the latest keyhole surgery, surgeons opened a small incision (about 6cm) in Simon’s chest.
They used the same hole to insert an endoscopic camera and tiny instruments to excise and replace the diseased valve, controlling the procedure while watching it on a monitor. Having connected Simon to a heart-lung machine, which took over the function of the heart, doctors temporarily stopped the heart while working on it.
Moving the miniature instruments delicately inside the heart while watching on the screen, surgeons loosened the diseased valve and removed it before replacing it with a prosthetic valve.
Scherman said the latest surgery meant patients who came to that hospital would not have to go through the surgical trauma of splitting the breastbone.
“These minimally invasive surgical approaches result in much less surgical trauma, which translates into faster recovery times, fewer reported complications and greater patient satisfaction,” he said.
As Groote Schuur plans to train more doctors, it was hoped key-hole heart surgeries would be expanded to other public hospitals, benefiting many who were dependent on the public health-care sector.
sipokazi.fokazi@inl.co.za
Cape Argus