TWO heart specialists at The Essex Cardiothoracic Centre (CTC) at Basildon University Hospital have successfully carried out a dual operation on a patient with two types of heart disease; the first of its kind in the country.
The double operation took place in the Â£1.3 million state-of-the-art hybrid operating theatre in the CTC, which combines sophisticated imaging technology with the best equipment required for surgery, so that both cardiology and surgical procedures can be carried out at the same time.
Mrs Cherie Bason, 65, was leading a very active life. She enjoyed gardening and walking with her husband, regular gym sessions and even kick-boxing classes. But a lingering cold and bad chest led her GP to send her for tests, and she was diagnosed with two heart-related problems: coronary artery disease, which in her case had caused a severe narrowing in one of the arteries that supply blood to the heart; and a severe leak in her mitral valve, which controls blood flow through the heart chambers.
The usual way to treat this combination of problems would be open heart surgery, with a repair to the mitral valve and a bypass graft on the narrowed artery. This operation would involve the breastbone being cut in two, with a vein being taken from the leg.
Paul Kelly, consultant cardiologist and Inderpaul Birdi, consultant, cardiac surgeon, conferred on the case with other specialist colleagues at the CTC. They established that it could be possible and far less traumatic for Mrs Bason, to have a combined operation, with a coronary angioplasty to widen the blocked artery, followed immediately by a keyhole mitral valve repair. The healing time following keyhole surgery is about seven to 10 days, compared to 12 weeks if the breastbone is cut.
They explained this to Mrs Bason, who consented to be the first patient in Britain to have an operation of this kind.
Mrs Bason was anaesthetised, and Mr Birdi exposed the artery in her right groin. Dr Kelly inserted a fine guidewire down the artery and a stent was used to open the narrowing.
A repair to her mitral valve was performed immediately after by Mr Birdi. A small incision was made between Mrs Bason’s ribs and the mitral valve was repaired using a keyhole heart surgery technique perfected at the CTC.
Mr Birdi explains: “We have been performing keyhole heart surgery at the CTC for several years now and patients recover so much quicker than if we divide the breastbone. Until now, those patients with valve problems and coronary artery disease were only offered traditional surgery.
“We have succeeded in combining two keyhole techniques and the outcome speaks for itself. This will now allow patients who were previously believed to be unsuitable for keyhole surgery to benefit from the technique.
“There are risks attached to all surgical procedures, but it was much safer for Mrs Bason that Dr Kelly and I were able to carry out a combined operation involving only one anaesthetic and one hospital admission and reducing the time she spent in theatre. Both procedures require wires and tubes to be inserted, and as this had to be done only once it reduced the risk of infection and scarring.”
Dr Kelly said: “We could only have performed this double operation in the hybrid theatre at the CTC because we needed surgical and cardiology facilities. Keyhole mitral valve repair requires the highest level of imaging, but does not need X-ray as cardiology does, but this theatre has both.”
Mrs Bason, a retired bank cashier from Thorpe Bay, was able to return home four days after her operation.
She said: “When I was referred to Dr Kelly and he said he would talk to Mr Birdi about me, I did some internet research. I saw that Mr Birdi is a leading expert in keyhole surgery. When I met him I asked if I would be suitable and he explained that my recovery would be much quicker.
“I was absolutely amazed that I was able to go home so soon after such an operation. I feel very well and it is already easier for me to climb the stairs. All the hospital staff were so kind and reassuring; we are very fortunate to have the CTC in Essex, with doctors who are leaders in their field, so we don’t have to travel across the country for these sort of operations.”
The team at the Essex Cardiothoracic Centre Hybrid Theatre during Mrs Bason’s operation
Mrs Bason has been back to the CTC for a follow-up appointment, and will be assessed by the cardiac rehabilitation team soon after that.
She added: “I am keen to get active again, and they have said they will prepare me to get back to the gym. Kick boxing might take a bit longer but I intend to start it again – I like the loud music as well as the action!”