National Taiwan University Hospital (NTUH) has performed its 100th keyhole heart surgery, which is a safer method to treat congenital heart disease and requires less recovery time by replacing a pulmonary valve with a self-expandable valve, the hospital said on Monday last week.
One out of every 3,000 to 4,000 people born in Taiwan have tetralogy of fallot (TOF), a congenital heart defect made up of four abnormalities of the heart and its vessels, Wang Jou-kou (王主科), a clinical professor at the College of Medicine at National Taiwan University, told a news conference.
The abnormalities include pulmonary stenosis, a narrowing of the pulmonary valve and main pulmonary artery, and ventricular hypertrophy, a condition in which the muscular wall of the right ventricle is thicker than normal, according to the US Centers for Disease Control and Prevention.
Photo: CNA
After undergoing surgeries during childhood to correct the abnormalities, about 30 percent of those with TOF develop pulmonary valve regurgitation when they reach adulthood, in which the pulmonary valve fails to close completely and allows blood to leak back into the heart, Wang said.
As a result of pulmonary valve regurgitation, the right ventricle also gradually enlarges, eventually requiring a valve replacement, he said.
Surgical pulmonary valve replacement is the traditional cardiac surgery to replace the pulmonary valve, which typically requires seven to 10 days of recovery, NTUH Department of Pediatrics deputy chairman Lin Ming-tai (林銘泰) said.
By comparison, transcatheter pulmonary valve replacement (TPVR), a less-invasive alternative, is less risky and reduces the recovery time to just one day, Lin said.
Featuring a self-expandable valve delivered to the heart through a small incision in the lower body, TPVR has been available to NTUH patients needing pulmonary valve replacement since 2015 and has been covered by National Health Insurance since Dec. 1, 2021, the NTUH team said.
As of Monday last week, the NTUH team, which was designated in 2021 as Taiwan’s sole guidance team for the TPVR procedure, has performed 102 of the surgeries, 100 of which were successful, Lin said.
In the 100th case, a 28-year-old woman with TOF surnamed Chang (張), shared her experience before undergoing TPVR last month.
She said she would get out of breath easily just from walking and felt fatigued all the time.
“My life now is completely normal,” Chang said after the keyhole surgery, adding that she can climb stairs without feeling tired.
With their extensive experience in performing TPVR, some NTUH doctors have been invited to the Philippines to treat patients with pulmonary valve issues, while hospitals in Indonesia and Vietnam have sent doctors to NTUH for training, Lin said.
Indonesian and Vietnamese doctors “observed how smoothly we are able to replace the valves and realized that their patients could also benefit from this treatment,” he said.
The NTUH team would have an opportunity to perform TPVR in Vietnam and Indonesia in the near future, he added.
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