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Cleveland Clinic Abu Dhabi completes surgical first in UAE

ABU DHABI, Physicians at Cleveland Clinic Abu Dhabi have successfully performed a valve-in-valve transcatheter mitral valve replacement (VIV-TMVR) in a clinical first for the United Arab Emirates.

The 77-year-old patient, Sfeir Iskandar, who had a history of prior coronary artery bypass graft surgery (CABG) and mitral valve replacement, was referred to the specialists at Cleveland Clinic Abu Dhabi with recurrent heart failure.

He was found to have severe mitral valve regurgitation (valve leaking) and failure of his mitral valve. His complex case was further exacerbated by the fact that he had multiple medical problems, having previously suffered a stroke, and been diagnosed with kidney disease, while also being significantly frail.

Dr. Ahmad Edris, Interventional Cardiologist at Cleveland Clinic Abu Dhabi’s Heart, Vascular and Thoracic Institute, explained, “We are at a stage in our structural heart programme that we can treat very complex valvular heart disease using minimally invasive techniques with excellent outcomes.”

The treatment involved using a transcatheter heart valve, typically used in the aortic valve position for transcatheter aortic valve replacement (TAVR). The valve was delivered across the interatrial septum from the right to left-side of the heart after making a puncture in the septum (tissue between the right and left side of the heart) and delivered to the mitral position. The patient got discharged from the hospital in two days.

Dr. Edris is the co-director of the structural heart programme with Dr. Mahmoud Traina and both work collaboratively with the cardiac surgery team to make the best treatment decision for each patient. Dr. Ahmed Bafadel from cardiac imaging helped with cardiac CT planning and procedural imaging.

The procedure was performed in collaboration with the structural heart team physicians at Cleveland Clinic Foundation, in the United States, via web conference.

Valve disease continues to be prevalent in the United Arab Emirates. Symptoms include a slow decline in functional ability and shortness of breath with exertion which, if ignored, can have serious consequences. For example, approximately 60-70 percent of symptomatic severe aortic stenosis continues to go untreated despite the available non-invasive treatment options.

“I don’t know whether patients or families truly understand the importance of seeking cardiac evaluation and treatment early in their heart condition. We often see patients at the end-stage of their disease process when it carries the highest risk of death if left untreated,” Dr. Edris added.

Source: Emirates News Agency