The first ever Transcatheter Aortic Valve Implantation (TAVI) undertaken in the English-speaking Caribbean region has been completed at leading tertiary care hospital, Health City Cayman Islands.
The complex cardiac procedure was performed on local Cayman Islands patient, Dianna Merren, in February 2016, by Health City Senior Cardiologist, Dr Ravi Kishore and Senior Cardiac Surgeon, Dr Binoy Chattuparambil and guided by proctor, Dr Stephen Brecker from St George’s Hospital in London. The procedure was assisted by Senior Anaesthesiologist, Dr Dhruva Krishnan.
Dr Ravi Kishore, Senior Cardiologist and Electrophysiologist at Health City Cayman Islands said the cardiovascular department at Health City made its foray into structural heart disease interventions by successfully implanting the aortic valve using transcatheter techniques.
“This is indeed a proud moment for Health City and the Cayman Islands, as successful completion of such a complex procedure speaks volumes about the capabilities of our doctors and what we have been able to achieve as a hospital in just under two years,” he said.
The Transcatheter Aortic Valve Implantation (TAVI) procedure is performed only on patients who are not suitable for open-heart surgery, of which Dianna Merren was an ideal candidate.
Merren was regularly admitted to a hospital for heart failure due to a large obstruction of the valve connecting the major chamber of the heart (Severe Valvular Aortic Stenosis). Her complex condition and multiple medical complications precluded her from the usual procedure choice for this condition, surgical valve replacement.
“I have been very sick for a long time, so when the doctors at Health City offered me a safe solution I was very grateful,” Dianna Merren said. “Being the first patient for this procedure made me a little nervous, but the wonderful medical team put my fears to rest, providing me with all the information I needed to understand the procedure and the risks. I am so thankful to my family and friends who stood beside me in support, as well as the entire Health City team. The surgery has changed my life, and I am already feeling much stronger and healthier.”
The TAVI procedure is a minimally invasive surgery that replaces the valve without removing the old damaged valve. Unlike conventional open heart surgical procedure, TAVI involves placement of the artificial valve through a 6-7 millimetre hole in the upper thigh under general anaesthesia. The procedure took just under two hours, and the patient was discharged within a couple of days.
“It’s a game changer,” Dr Ravi Kishore said. “We have performed our first TAVI to relieve this 75-year-old woman from severe life-threatening problems caused by a diseased valve. The outcome is extremely promising.”
Dr Kishore said reduced morbidity was the biggest advantage of the procedure. “The hole made for insertion of the valve is closed immediately after the procedure and the patient is mobilized in 12-24 hours of the procedure.” He said “This procedure also reduces risk of complications and infections, which in the case of Dianna Merren was a primary concern.”
The TAVI procedure is available at an extremely high cost at selected private centres in the United States, covered by Medicaid/Medicare, however, patients who qualify for this procedure will now have the opportunity to choose Health City Cayman Islands as their hospital of choice for this surgery.
As JCI Accredited Health City Cayman Islands is the first English-speaking country in the Caribbean to perform the TAVI, this provides breakthrough opportunities in the field of interventional cardiology in the Cayman Islands and the Caribbean.