Posted on Tuesday 31 October 2017
Olasumbo Yates became the first patient in the UK to have the pioneering Arto device implanted last year.
An innovative procedure which repairs leaking heart valves without the need for invasive surgery has been carried out at St Thomas’ Hospital in a UK first.
The pioneering technique uses equipment known as an Arto device to pull a stitch across a leaking mitral valve and then tightens it to stop the leak.
Around one in 50 adults in Britain is thought to have mitral regurgitation. This is when the mitral valve (which controls blood flow through the upper and lower left chambers of the heart) fails to close properly. As a result, blood flows backwards through the valve, compromising the function of the heart. The condition can cause breathlessness, fatigue, dizziness, chest pain and, if left untreated, can lead to heart failure and death.
Professor Simon Redwood, consultant cardiologist at Guy’s and St Thomas’ NHS Foundation Trust, performed the new technique for the first time in the UK as part of the international MAVERIC (MitrAl ValvE RepaIr Clinical) trial.
With the patient under a general anaesthetic, an ultrasound scan of the heart is undertaken by inserting a camera through the mouth into the oesophagus (gullet), which shows how much blood is leaking from the mitral valve.
Two catheters (thin, flexible tubes) are inserted through veins in the neck and leg and are fed through the body until they reach the mitral valve. Magnets are used to create a small hole through the wall of the upper left chamber of the heart, at one end of the mitral valve. A tiny metal T-bar is then positioned in the hole and a stitch is released across the width of the valve. Two discs on a spring are released from the other catheter, which sit at the other end of the mitral valve. The stitch is pulled across the valve through the discs and is tightened until the ultrasound shows that the leaking has stopped. The stitch is locked and cut, and the device remains inside the heart.
Olasumbo Yates, a pharmacist from Blackheath in south-east London, became the first patient in the UK to have the procedure. She developed mitral regurgitation after having a heart attack in 2011. It is thought that the heart attack damaged the part of her heart which holds the mitral valve in place, making it leak.
Olasumbo, 55, says: “Last year I suddenly started to get breathless and very tired. I could barely function and struggled to get through working two days a week. No matter how much rest I got I needed more and I had to cut all activities down to a minimum.”
She was told about the Arto procedure and had it in September 2016 after a series of tests. Olasumbo, a mother of two, recalls: “The difference was immediate. When I woke up I felt lighter and I was eager to get out of bed. I could walk at my usual slow pace without feeling tired, which was a big improvement.
“Now I’m able to work three days a week and, provided I pace myself, I have a lot more energy. The procedure has given me a whole new lease of life and I’m so grateful I had it.”
Professor Redwood explains: “It is too early to say if the Arto procedure is better than other treatments for mitral regurgitation but it is very safe and easy to do.
“Patients are usually able to go home within a couple of days of having the procedure and they can feel the benefits straightaway. It is important to understand more about the long-term benefits of the device which should become clearer when more patients are treated with it. So far nearly 50 patients have had the procedure worldwide and Guy’s and St Thomas’ is one of only two centres in the UK carrying out the treatment.
“Everyone’s anatomy is different so not all treatments are suitable for patients, which is why it is beneficial to have more options to offer them.”
To find out more about research taking place at Guy’s and St Thomas’ please email firstname.lastname@example.org