Cardiac world first at Mediclinic Panorama

History was made at Mediclinic Panorama on 5 January 2013, when a team of doctors performed the world’s first non-surgical closure of a leaking heart valve on a 59-year old female patient with the physical anomaly known as dextrocardia with situs inversus.

People with this condition are born with their hearts transposed in a mirror image of what is considered anatomically normal. In other words, it is located on the right side of their chests.

‘This procedure is technically extremely difficult in a patient with normal anatomy, and has never been done before on someone with dextrocardia,’ says Dr Hellmuth Weich, the cardiologist who performed the procedure in the catheterisation laboratory of the hospital. He therefore arranged for two world experts in the percutaneous closure of such valve leaks to assist the team. The duo, Professor Eric Eeckhout and Dr Alain Delabays, flew to Cape Town from Lausanne, Switzerland specifically for the case.

As a result of rheumatic fever at a young age, Mrs Marianna Cronjé from Stellenbosch had undergone four open-heart operations over a period of 40 years. Her last valve replacement in 2000 was successful, but due to scar tissue and other difficulties, this was considered her last operation. When this valve developed a leak, she had no surgical options and her condition deteriorated gradually to the point where she could do nothing for herself. She was referred to Dr Weich who practices at Mediclinic Panorama and Stellenbosch University, Tygerberg Hospital, as a candidate for a percutaneous (non-surgical) alternative.

The entire procedure was performed through a needle puncture in the patient’s groin. A tube was fed through a vein up into the right side of the heart and then a hole had to be made in the wall of the heart to get across to the left side of the heart. From here the leak in the mitral valve had to be crossed and was then closed with two disc-like devices, which are actually intended for closing birth defects in children’s hearts.

‘The six-hour procedure went well thanks to an excellent team of medical professionals. Mrs Cronjé  is making a slow recovery in hospital,’ Dr Weich says. He cautioned that although the procedure was successful, her condition was poor prior to the surgery and that recovery may take a month or more.