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Congenital pulmonary valve

defects

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

the treatment.

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

the NUHCS”).

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.

evidence+

OCT 2016

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