Another milestone achieved for Tygerberg Hospital

Source: Supplied. PN Siyavuya Nolanda, PN Likho Gubelana, Dr Hellmuth Weich, Mr Nathan Yamey, and PN Rita Plaatjies.

The procedure, which took place on Wednesday, 10 April 2024, is the first time the new treatment - the Tootsie Roll technique - was performed on this type of prosthetic heart valve.

Patient Nathan Yamey (86) received a transcatheter aortic valve implant (Tavi), a minimally 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, it was decided to offer him a procedure where a small plug is placed in the hole next to the valve.

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 tested in the specific type of THV that Yamey has.

This minimally invasive procedure is done through a thin catheter advanced through an artery in the groin up to the heart. A small tubular stent is then 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 has 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," said Yamey.

According to treating cardiologist, Hellmuth Weich, "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 that the Tootsie roll technique will provide better results for this type of problem and may become our preferred method."

Yamey was discharged the next day and is already looking forward to his first round of golf, Weich said.