Previously ‘Untreatable’ Patients Benefit from Innovative, Complex Non-Surgical Procedure

Previously untreatable patients with severe tricuspid valve regurgitation in their hearts can now benefit from an innovative new procedure to control their symptoms as Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health, joins a handful of hospitals worldwide with the expertise to perform it.

Tricuspid valve regurgitation occurs when the heart valve no longer closes completely when the heart beats. This allows blood that pumps into the heart to flow back out in the wrong direction, leading to increased pressure that floods the body with excess fluid. This fluid can build up in the body’s tissue, causing swelling in the legs and organs that significantly impacts a patient’s quality of life.

The symptoms caused by tricuspid valve regurgitation can usually be controlled with medication to help the body reduce the buildup of fluid.  However, until recently, patients who did not respond well to medication had no viable options to control their condition as surgery to repair it is extremely high risk. Recent technological advances have meant that physicians at a handful of centers around the world have begun exploring non-surgical methods to restore lost heart valve function.

“The tricuspid valve is perhaps the hardest of the four valves of the heart to work on – particularly when taking a percutaneous approach. The challenge is that the tricuspid valve is significantly harder to see than the mitral valve, for example. Happily, thanks to advances in imaging technology and a tremendous amount of dedication and effort from my colleagues in our cardiovascular imaging section, we are now able to get a good enough view to repair the valve percutaneously (through the skin) – benefitting patients who were previously untreatable,” explains Dr. Mahmoud Traina, an interventional cardiologist at Cleveland Clinic Abu Dhabi. 

Doctors at Cleveland Clinic Abu Dhabi spent months working on their imaging capabilities and refining their technique in preparation for their first procedure to repair a patient’s tricuspid heart valve- the first time it has been performed in the UAE.

“Over the last few months, we have worked closely with our interventional cardiology team during procedures to improve our focus on this valve and dial in the details to make sure we can see each individual part. It took a lot of clinical research to improve our imaging capability, building on a great deal of advances in real time and 3D imaging to make all this possible”, says Dr. Ahmed Bafadel, director of structural imaging at Cleveland Clinic Abu Dhabi.

During the three-hour, minimally invasive procedure, doctors insert a small device that clips onto the flaps that seal the tricuspid valve and ensures they make a strong seal to prevent blood from flowing back through. This device is inserted through a vein in the patient’s leg and carefully guided to the heart. Doctors can see what they’re doing thanks to an advanced form of ultrasound and place the device while the heart is still beating. This approach is significantly safer than open heart surgery and allows patients to regain lost quality of life caused by fluid buildup.

“This was certainly one of the hardest procedures I’ve ever done in my career. I am very glad that we have such a remarkable team in place here and a close relationship with our colleagues at Cleveland Clinic in the United States. They’ve done a lot more of these procedures so were able to give us direct guidance during the procedure as well as some tips and tricks that proved invaluable,” continues Dr. Traina.

The first ever patient to benefit from the new and innovative procedure is Afra, a 77-year-old UAE national. She has spent the last two years in and out of hospitals due to excessive fluid buildup in her legs and internal organs caused by her tricuspid valve regurgitation. As a result, she was no longer able to live a full and active life. Since undergoing the procedure, her quality of life has improved significantly, and she is looking forward to being able to return to her farm and care for her plants once again. 

“I am so thankful to the people that brought this treatment to the UAE, my doctors and Cleveland Clinic Abu Dhabi. When Dr. Traina told me that the procedure is minimally invasive and is not a major operation, I felt huge relief. The last few years have been hard but I have faith that we are always in good hands. Now I am looking forward to doing the things I love and caring for my small farm here at home.” Says Afra. 

For more information or to book an appointment at Cleveland Clinic Abu Dhabi, call 800 8 CCAD (2223) visit www.clevelandclinicabudhabi.ae or download the Cleveland Clinic Abu Dhabi app.

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