Tygerberg Hospital in Cape Town has reached another milestone with firsts after a team of doctors performed a unique procedure to repair a patient’s leaky heart valve.
The Western Cape Department of Health and Wellness said the procedure took place on April 10, and it is the first time the new treatment, named Tootsie Roll technique, was performed on this type of prosthetic heart valve.
The patient, Nathan Yamey, 86, received a transcatheter aortic valve implant (TAVI), a minimal invasive heart valve replacement in 2023. There was a large leakage of blood past the outside of the valve, which caused him to be very short of breath. After all conservative measures failed, a procedure where a small plug is placed in the hole next to the valve was offered to him.
“This procedure is technically very demanding and often not very successful, but a new variation was published in March 2024 in the Journal of the American College of Cardiology which showed that the technique may effectively treat transcatheter heart valve (THV)–related paravalvular leak (PVL). It has, however, not been tested in the specific type of THV that Mr Yamey has,” the department said.
The procedure is done through a thin catheter advanced through an artery in the groin up to the heart. A small tubular stent is deployed in the defect and a plug developed to block arteries is deployed inside the tubular stent. This tube was nicknamed the Tootsie Roll after an American tubular chocolate bar that’s been in production since 1907.
“Previously, I was always tired and had no energy. Today, I can feel the difference. Thank you to the entire team that made this possible,” Yamey said.
Dr Hellmuth Weich, the treating cardiologist said this case was the first time the technique was used.
“This is the first case where this type of technique was applied to this type of valve and the immediate result was a big success with the complete cessation of the leak. Although it is early days, we believe the Tootsie Roll technique will provide better results for this type of problem and may become our preferred method.
“Mr Yamey was discharged the next day and is already looking forward to his first round of golf,” Weich said.
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