King’s College Hospital in London has carried out the first aortic valve replacement using a new device that will benefit people with aortic valve disease, particularly women wanting to get pregnant and young patients who want to live an active life without having to take life-long medication.
Until now, patients below the age of 65 with a damaged aortic valve would have it replaced with a mechanical heart valve. Although they can last for many years, patients have to take life-long Warfarin to thin the blood because of the tendency for clots to form on the valve. Blood thinning medication can cause problems during pregnancy and damage an unborn baby.
Biological heart valves, made from animal tissue, do not require patients to take blood thinning treatment but due to their tendency to need replacing regularly they were previously considered unsuitable for use in younger patients. However, for women wanting to get pregnant they were the best option available.
Twenty-seven year old Nosheen Khan from Croydon was the first patient in the world to be fitted with the new device. At the age of two she was diagnosed with aortic valve disease – a narrowing and leaking of the aortic valve in the heart. The condition restricts blood flow through the heart valve which means the heart has to squeeze harder to pump blood into the aorta. Over time, the condition can worsen and lead the sufferer to experience symptoms of heart failure such as shortness of breath.
Nosheen’s operation was carried out using minimally invasive techniques and as a result she was home five days after surgery. Nosheen said, Nosheen said, “I’m very keen to start a family with my husband Dr Saqib Haroon, so when Professor Wendler told us about this new device, we agreed it would be the best option for us. We are hopeful that the new valve will also prevent the need for numerous heart operations in the future.”
Olaf Wendler, Professor of Cardiac Surgery at King’s College Hospital, who carried out the procedure said, “Although we have been replacing damaged aortic valves for many years, this new device is a game-changer for patients who do not want to take blood thinning medication, especially women hoping to start a family.
“We have avoided using mechanical valve prostheses in this group of patients due to the problems associated with blood thinning medication and pregnancy, and have relied on biological prostheses with limited durability. As a consequence, younger patients have required multiple open heart surgeries. This new prosthesis combines the best from both devices; it’s durable and patients do not require blood thinning medication. This means fewer operations, the possibility of a healthy pregnancy and a good quality of life.”
Currently around 35,000 patients undergo open heart surgery on the aortic valve per year. Of those, approximately 40% are below the age of 65. Aortic valve replacement with a durable device not requiring anticoagulation treatment (Warfarin), could significantly improve patients’ quality of life and future prognosis.