The days when a heart operation meant hours in an operating theatre, with weeks and even months of convalescing, will soon be something of the past.

A team of cardiologists from the University of the Free State’s (UFS) Faculty of Health Sciences once again made medical history when they performed the first hybrid procedure in the Free State.

The Department of Paediatric Cardiology, in conjunction with the Department of Cardiothoracic Surgery, performed this very successful procedure on a 45-year-old woman from Kuruman.

During the procedure of 30 minutes, the patient’s thorax was opened up through a mini thoracotomy to operate on the beating heart.

“The patient received an artificial valve in 2011. Due to infection, a giant aneurism developed from the left ventricle, next to the aorta. Surgery would pose a very high risk to the patient. Furthermore, her health was such that it would contribute to problems during open-heart surgery,” explains Prof Stephen Brown, Head of the UFS’s Department of Paediatric Cardiology.

“After the heart was opened up through a mini thoracotomy, the paediatric cardiologists performed a direct puncture with a needle to the left ventricle cavity. A Special sheath was then placed in the left ventricle to bypass the catheters. Aided by highly advanced three-dimensional echocardiography and dihedral X-ray guidance, the opening to the aneurism, located directly below the artificial aorta valve, was identified and the aneurism cannulated.”
 
During the operation, a special coil, called a Nester Retractor, was used for the first time on a patient in South Africa to obtain stasis of extravasation and ensure the stability of devices in the aneurism.

“This is highly advanced and specialist work, as we had to make sure that the aneurism doesn’t rupture during manipulation and the devices had to be positioned in such a way that it doesn’t cause obstruction in valve function or the coronary artery. The surgical team was ready all the time to switch the patient to the heart-lung machine should something go wrong, but the procedure was very successful and the patient was discharged after a few days.”