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Surgeons score a 'first' in Borneo

Published on: Wednesday, February 19, 2014

Kota Kinabalu: Three surgeons became the first in Borneo to implant the "Edwards Rapid Deployment Intuity Valve" in three patients suffering from severe aortic stenosis with coronary artery disease.

Consultant Cardiothoracic Surgeons with Queen Elizabeth Hospital II (QEH II) Dr David Tang and Dr Abu Bakar and Royal Melbourne Hospital, Australia Dr Marco Larobina performed the surgeries on Nov 28 and 29 last year at the QEH II.

Dr Tang performed two of three surgeries while one was performed by Dr Abu Bakar. All surgeries were assisted by Dr Larobina.

The three patients were discharged from the hospital eight days after the surgeries.

The first patient is a 75-year-old man from Labuan who had a calculated risk of mortality of 20 per cent (based on EUROscore risk assessment) and needed coronary bypass surgery at the same time.

His original valve was removed and the new valve implanted while at the same time, his coronaries were also bypassed.

Aortic stenosis is a disease of various causes and for this man it was due to senile atherosclerotic degeneration of the valve.

This valve is the main valve that allows blood to be pumped out of the heart to supply to the rest of the body.

In a normal person it has an area of 2.5-4.0cm2 but the elderly man had an area of 0.5cm2. When diagnosed they are unlikely to survive 2-3 years. This is considered an end stage aortic valve heart disease.

The patient also had his coronaries bypassed as they were also obstructed increasing the risk of his surgery.

The usage of such a valve helps to lower the risk of surgery.

The Edwards Intuity valve, manufactured by Edwards Lifesciences Inc. USA, is a sutureless valve specifically designed for very high risk aortic stenosis (mixed or pure) patients who are elderly with multiple comorbidities and who are considered to have a high risk of perioperative mortality.

Only about 1,500 of such valves have been implanted worldwide since late 2011; Malaysia is the first in Asia to implant these valves with IJN having implanted six.

QEH II is the first government hospital to implant these new category of valves - both the Intuity as well as 3F Enable valves.