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Last Updated: Saturday, 22 July 2006, 23:07 GMT 00:07 UK
UK doctors' heart repair advance
Heart attack
A heart attack can cause damage to the heart wall
UK doctors have been able to repair heart attack damage without using open-heart surgery, they have revealed.

The King's College Hospital London team used a 10mm-long device to plug a gap in the heart wall of a 75-year-old man.

Olaf Wendler, who carried out the procedure, said the less invasive technique was "a huge step forward".

Heart experts said the work was a "welcome advance" in treating inner heart wall ruptures - an "uncommon but devastating" heart attack complication.

Each year, around 230,000 people in the UK have a heart attack.

Of those, between 1% and 2% experience an inner rupture of the heart wall, which is fatal in most cases.

The hole allows blood to flow from the high pressure left heart chamber into the low pressure right heart chamber, which can cause severe breathlessness and low blood pressure.

There is also risk of multiple organ failure.

Strain of surgery

Open-heart surgery, in which a patch is stitched over the hole, can be used to repair the damage but it requires surgeons to open up both sides of the heart.

It puts great strain on the body and around half of patients who undergo the procedure die.

In this case, the heart attack patient needed a quadruple bypass and to have the hole in the heart wall repaired.

The tiny device used to plug the hole has previously been used for children with heart conditions and patients with long-term holes in the heart.

It has not before been used in heart attack surgery cases, in which tissue is much more damaged.

Umbrella shapes

Heart surgeon Mr Wendler and Dr Jonathon Hill carried out the procedure at King's after the patient's quadruple heart bypass.

After normal blood supply had been restored, the tiny device - made of rolled up metal mesh - was placed into the hole in the heart wall via an incision in the right heart.

It was then unfolded so it formed umbrella shapes on either side of the wall, with a segment in the middle filling the hole.

The patient was taken off the mechanical ventilator the next morning and was able to return home a few weeks later.

'Less invasive'

Mr Wendler said: "This represents a huge step forward in treatment of heart rupture.

"Until now, the only way we had of treating inner rupture to the heart was the conventional open-heart surgery, with its high risk.

"Because we are now able to use this less invasive approach we hope to have better results in the future.

"We are encouraged by this outcome and we will be exploring the possibility of establishing this as a regular procedure for suitable patients."

Dr Mike Knapton, director of prevention and care at the British Heart Foundation, said: "This is a welcome advance in the surgical treatment of ventricular wall rupture, which is an uncommon but devastating complication of heart attack.

"Surgical treatment to repair the rupture is required and this new procedure reduces the trauma to the already damaged heart."




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