Congenital pulmonary valve
a ect 0.8% to 1% of all
patients born with a heart disease.
The pulmonary heart valve allows
low-oxygen blood to be pumped
from the heart to the lungs to be
replenished with oxygen. If the
valve is improperly formed or does
not exist, the blood pumped out
from the heart flows back and not
enough of it reaches the lungs. This
results in oxygen shortage in the
rest of the body.
Some patients or their
families see each surgery
as ‘testing fate’.
Dr Edgar Tay, National University
Heart Centre, Singapore
introduced a new minimally invasive procedure that
can help to reduce the number of major surgeries
needed in a lifetime. The doctors worked with
imaging specialists and surgeons to push out
This new approach involves inserting an artificial
valve within the deteriorated implant to prop up its
walls and re-open it, explains Dr Tay. A thin tube,
which contains the specially-designed valve (see
sidebox on page 6: “The minimally invasive valve”),
is inserted through a vein in the leg, pushed up to
the heart and into the failing implant.
According to Dr Tay, this procedure does not
replace open heart surgery but o ers the
possibility of delaying the next time the high-risk
operation is needed. Studies in the United States,
Europe and Canada have shown that over 90% of
patients did not need open heart surgery five years
a er the minimally invasive intervention.
The treatment is part of the Congenital and
Structural Heart Disease Programme, one of
NUHCS’ core clinical areas (see page 7: “About
Fewer operations, more benefits
Associate Professor Quek Swee Chye, who heads
the NUH Division of Paediatric Cardiology, says the
new method o ers significant benefits for patients,
many of whom have undergone surgeries in their
younger days. “With each open heart surgery, the
risks become higher because the chest had been
previously opened, and there is underlying scar
tissue which makes surgery more di cult,” says the
Senior Consultant, who works closely with Dr Tay
on the procedure.
Apart from reducing surgical risks, the minimally
invasive approach also lowers the psychological
trauma associated with a major surgery.