Heart patients get a safer option

SINGAPORE - For the past three years, Madam Magaret Lim would feel breathless after walking just a few steps.

"I always felt tired and never wanted to leave my house," the 68-year-old said in Mandarin.

Doctors discovered that she had a condition known as mitral regurgitation.

It occurs when the mitral valve inside the heart does not close tightly, allowing blood to flow back into the heart, instead of being pumped to the rest of the body.

The standard procedure for treating the condition - open-heart surgery - was deemed too risky for Madam Lim as she has a history of lung disease and also had a heart bypass in 2008.

But earlier this year, Madam Lim was chosen by doctors at National Heart Centre Singapore (NHCS) to undergo Asia's first minimally invasive heart-valve repair operation, called the mitraclip procedure.

It involves delivering a tiny clip to the heart through a tube inserted from the groin area. The clip is then fastened onto the leaflets of the faulty valve, helping to reduce the leakage of blood.

Dr Yeo Khung Keong, a consultant at NHCS department of cardiology and the lead surgeon for the procedure, said severe cases of mitral regurgitation can lead to an irregular heart beat, heart failure or even death.

NHCS performs about 100 operations every year to repair mitral valves. The condition affects about 12 per cent of those aged 75 and above worldwide.

One of its main causes is a heart attack that damages the muscles supporting the mitral valve. At a press conference held yesterday at NHCS, Dr Yeo explained that the mitraclip procedure is best used to treat patients who suffer from severe mitral regurgitation.

In Madam Lim's case, chest surgery could have damaged heart- bypass grafts from her previous operation. The mitraclip procedure requires less blood transfusion and less time spent hooked to a breathing machine, both of which pose risks of infection.

"Overall, the patients will feel better sooner. They recover faster and have a shorter hospital stay," Dr Yeo said.

Madam Lim was discharged from hospital just three days after her procedure.

"I felt no pain afterwards. Now I have more energy to go out and chat with my friends," she said.

The mitraclip device costs $40,000, much more the typical cost of $1,000 for devices used in open-heart surgery, such as a ring that helps support the valves.

The cost of Madam Lim's device was borne by the SingHealth Foundation.

nggwen@sph.com.sg

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