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In the past if I walked for 6 minutes
I would feel
breathless.
Now I can walk
say, a mile, two miles.
I was told that
I was not fit for the
general surgery--
open heart surgery-- to replace the mitral valve
and that a new-
and that I may be a candidate for the new procedure.
I met George when he came to the hospital.
He went through a number of investigations, including an exercise
echocardiogram.
We knew he was limited by symptoms, but we wanted to assess the mechanism of the symptoms,
to see exactly what was causing his breathlessness on exertion.
We were scanning his heart with the three dimensional echocardiogram
and we described the lesion of the valve
in great detail
and the magnitude of the problem.
Twenty years ago,
the surgeon
needed to go into the heart first before they actually realised
what the
lesion, the pathology, looked like.
Nowadays
the surgeon or the interventional cardiologist can plan the procedure
in advance.
The patient is taken into the Cath Lab with a valve condition
and is having a transesophageal echocardiogram at the same time.
This echocardiogram can be a 3D one or a 4D, which means that
we have live images of the heart all the time
and the catheters which are forwarded to the heart by
the interventional colleague
are being
viewed live on the screen.
So my interventional colleague knows exactly where the catheters are,
how the valve is being approached by the catheters,
then the device
which is
designed to fix a problem of the valve, to repair the valve,
is
deployed
on the valve.
In the past, when the interventional cardiologist worked on his own
in a lab with X-rays, it's now
changed, in that we're really part of a team.
And so the inventional cardiologists may be
the person moving the catheters but
really the imaging cardiologist, the one who provides the three-dimensional images,
and is really the navigator and
you have to integrate and work very closely with them, so in many respects
they're as much responsible for the intervention as you are,
you may move the catheter, but they tell you where to move it.
This is not
an operation, the chest remains closed. Everything
is performed by catherisation through the
femoral vein or artery
which means that the patient
can essentially go home on the following day.
This procedure has enabled me to carry on my daily life,
and palpitations are gone.
And I'm able now to walk without having any breathlessness.