MALAYSIA'S NATIONAL HEART INSTITUTE CREATES MEDICAL HISTORY IN ASIA

KUALA LUMPUR, Dec 4 (Bernama) -- Yet again, the National Heart Institute
(IJN) is at the heart of the matter, creating medical history.

This time, it has become the first medical institution in Asia to perform
the Transcatheter Aortic Valve Implantation (Tavi), using the Corevalve device,
to treat severe aortic valve stenosis.

Late last month, IJN successfully performed three Tavi procedures for two
consecutive days.

The procedures were performed by a team of seven IJN consultants led by
cardiologist and IJN Chief Executive Director/Medical Director Dr
Robaayah Zambahari.

They were assisted by a visiting consultant interventional cardiologist and
Corevalve proctor from Belfast, Ireland, Dr Ganesh Manoharan.

Aortic stenosis is a common disorder of the aortic heart valve and is
prevalent among the elderly population as the aortic valve leaflets undergo
degeneration and calcification, as part of the aging process.

"When the stenosis is severe, it causes narrowing to the outflow tract of
the left ventride which is the main pumping chamber of the heart. As a result,
the left ventricle has to work harder to pump blood against an obstructed
outlet, resulting in symptoms of heart failure such as shortness of breath and
extreme fatigue," Dr Robaayah told a news conference at IJN here Friday.

She said such conditions would cause decrease of blood output to vital
organs of the body, which could lead to heart attack, stroke or sudden death.

Tavi procedure, which was first performed in the United States in 2002,
involves the use of a self-expanding nitinol stent frame that houses a tissue
valve in its mid-portion, which is fixed to the frame in surgical manner with
fine sutures.

Dr Robaayah said the stent frame had differential properties of expansion,
with
high radial force for fixation at the aortic annulus and pushes aside the
calcified native aortic leaflets, thus correcting the aortic valve disease.

She said this new surgical technique was considered safe as surgeons need no
longer arrest the heart to replace the diseased aortic valve.

The first procedure which involved a 73-year-old male patient with coronary
heart disease was performed on the morning of Nov 25, while another was done on
a 77-year-old male patient in the afternoon of the same day. The third Tavi
procedure was carried out on a 76-year-old male patient on Nov 26.

However, Dr Robaayah cautioned that Tavi was not recommended for frail,
elderly patients.

Cardiology Department head Dr Rosli Mohd Ali said the Tavi procedure
would cost about RM112,000 (US$33,101).

He said, between 12 and 15 patients were in the waiting list to undergo
treatment using Tavi, adding that each procedure lasted between 45 and 90
minutes.

Meanwhile, Dr Manoharan said the success rate of the procedure in the
operating theatre was 98 to 99 per cent, while the recovery rate and
complications faced by the patients after the surgery, might differ.

-- BERNAMA