UK first for “game-changing” new mitral valve implant

A football-mad grandad became the first person in the UK to benefit from a potentially “game-changing” new device to fix leaky heart valves.

Grandfather-of-seven Andrew Kiln, 76, had a mitral valve replacement implant at St Thomas’ Hospital by a team which was the first in the country and the second in Europe to successfully undertake the minimally invasive procedure using a SAPIEN M3 implant.

Andrew’s valve replacement procedure, which lasted an hour, was quicker than conventional open-heart surgery. This new procedure may be less risky especially for older or more frail patients, and may enable patients to recover faster which can mean a much shorter stay in hospital.

Led by Professor Simon Redwood, honorary consultant cardiologist, and Dr Tiffany Patterson, consultant cardiologist, the team at Guy’s and St Thomas’ operated on Andrew using a SAPIEN M3 mitral valve replacement implant as part of a clinical trial.

Doctors made a small cut in his groin and inserted a catheter (tube) into the vein and up through his body to the right side of the heart. Making a small hole, they passed the catheter into the left side of his heart. Special tubing was then inserted into the body through this catheter. This wrapped around the faulty valve flaps to create a secure docking point, then the new heart valve implant was inserted inside the docking point and expanded with a balloon mechanism to create the new mitral valve.

Andrew, a football referee from Ramsgate in Kent, had mitral regurgitation. This is a type of heart valve disease where the mitral valve, which separates the upper left atrium from the lower left ventricle in the heart, doesn’t close properly and as a result blood leaks back across the valve.

Mitral regurgitation affects one in 50 adults in the UK and 10 percent of people aged over 75. It can cause symptoms including dizziness, breathlessness and fatigue and over time can make the heart dilate, ultimately shortening a person’s life expectancy.

Conventional treatment for this condition is open-heart surgery, which involves risks, a lengthy hospital stay including time in intensive care, and can take patients months to fully recover. Due to existing adhesions and scars, it’s also not suitable for people like Andrew who have previously had open-heart surgery, leaving them with few options.

With this innovative valve replacement, Andrew was chatting to friends and family on the afternoon of his procedure, up walking around the hospital ward the following day and was discharged 48 hours after his operation.

Andrew said: “I didn’t have strong symptoms of the mitral regurgitation – I was refereeing football matches up until the weekend before my latest surgery. But the doctors told me it would get worse and they said this new implant could sort me out.

“I’ve been really well treated at St Thomas’ since 2000, so I trusted them. Now I’ve had it done, I’m pleased as punch. I can’t fault anything at all – even the food was good. I’m looking forward to getting back to the gym and seeing all my friends there.”

This type of mitral valve replacement implant could benefit many more patients with heart valve disease who may not be suitable for conventional surgery.

Dr Patterson said: “This minimally invasive procedure is game-changing. It gives patients a much quicker, smoother recovery, with a far shorter hospital stay of just a few days instead of months.

"It’s potentially safer, patients may need much less rehabilitation and it could be cheaper overall for the NHS. It’s potentially transformative for patients with heart valve disease, particularly for those like Andrew who would otherwise be turned down for conventional surgery.”

Prof Redwood said: “Mitral regurgitation (or a leaky mitral valve) is the commonest valve disorder we see. Although surgical mitral valve repair and replacement can be very successful procedures, many patients have other illnesses which may make surgery higher risk.

“We have been looking into various alternatives to surgery, and the availability of the M3 valve is a major step forward. This allows us to replace the valve through a small incision at the top of the leg, and the patients could typically be out of bed later the same day or the following morning and home within 1-2 days of the procedure, which is much lower risk with a quicker recovery than an operation. In time, we hope to be able to treat many more patients with this valve, which could have huge benefits to many patients.”

Andrew, who has played football for nearly seven decades and regularly referees children’s and adults’ matches in his hometown, had previous heart issues and surgery including a replacement aortic valve and two stents fitted. Since then, he has also volunteered to coach other heart surgery patients through their cardiac rehabilitation at his local gym.

Doctors had been monitoring his mitral regurgitation for years, but had previously advised he wouldn’t be able to have conventional surgery, until he had the opportunity to have the mitral valve replacement system at St Thomas’, as part of the ENCIRCLE trial.

Andrew added: “It’s exciting to be the first person in the country to have this done. Everyone at St Thomas’ has been excellent. I’ve been in the best hands and I hope they can do this on more people like me.