Medical first in Waikato offers hope to heart patients

Media Release

April 4, 2014

Medical first in Waikato offers hope to heart patients

Two weeks ago, Hawera farmer Glen Williamson could barely stagger 300m. He struggled to breathe, his legs were cold and clammy and he was as pale as a ghost.

“I looked like a walking corpse,” he says.

A tiny white butterfly clip changed that.

Williamson this month became the first New Zealander to have a clip inserted in his heart, which literally stops him drowning in his own blood.

The first transcatheter repair of a leaking mitral valve using the MitraClip device (Abbott Vascular) in New Zealand was performed successfully at Midland Cardio Vascular Services (MCVS) in Hamilton on March 22. The team of heart specialists led by Dr Rajesh Nair operated on two patients considered to be too high risk for conventional heart valve surgery. The second patient was Geoffrey Hill, from Hamilton.

The procedure took three hours and cost $86,000.

Glen Williamson says it was the price he was prepared to pay to get his life back.

Two days after the operation, he walked out of Braemar Hospital, where the procedure was carried out, and headed to his favourite spot at Mokau, where he intends taking some of his 16 grandchildren fishing.

Cardiac nurse Kath Phillips, who has been a nurse for 44 years, says the transformation made her cry. “(After the procedure) he was walking around so much he said his hips were sore. I said, ‘we haven’t fixed those’.”

The MitraClip is the only solution for patients who are too sick for normal heart valve surgery. When the mitral valve in the heart does not close properly the valve leaks blood from the left ventricle and into the left atrium. It commonly affects people who have had heart attacks, are older or who have rheumatic fever.

The clip, which looks like a white butterfly, the size of a 20c coin, clips together two heart valve leaflets, preventing blood from being regurgitated. The clip is delivered to the heart from a small cut in the groin, using a long tube. Patients receive a general anaesthetic but do not need open cardiac surgery and avoid the need for cardio pulmonary bypass. They recover sooner and notice immediate relief of their symptoms. Glen Williamson says while he was still in the operating theatre he told the surgeons, “I can breathe again.”

The procedure involves many disciplines and specialists and success depends on a collaborative approach. A team of three Waikato interventional cardiologists and other leading specialists carried out the first procedures at Braemar.

Dr Rajesh Nair, who led the team, says the success of the first MitraClip procedures is a major milestone for heart patients and offers hope for patients with heart valve disease in New Zealand for whom open heart surgery is not an option.

Dr Nair, who came to New Zealand three years ago and works as a consultant cardiologist at Waikato Hospital, has carried out MitraClip procedures in England and Denmark since 2008. He says MitraClip improves quality of life and reduces recurrent hospital admissions for patients “who otherwise do not have other definitive treatment options.”

MitraClip has been approved in Europe and the US for use on select patients. More than 10,000 procedures have been performed worldwide. In 2010 the device received approval from TGA on Australia and in 2014 received FDA approval for use on select patients. International guidelines recommend it as a treatment option in patients with severe mitral regurgitation, in whom the risk of conventional mitral valve surgery is considered very high.

The procedure has been commercially available for patients in New Zealand since 2008 but it is only available in the private sector.

Glen Williamson says he is keen to add his voice to the push to have the procedure publicly funded.

Less than a week after the operation, he was at his bach at Mokau preparing mutton chops for tea. He had just walked home from the village, more than half a kilometre away. He says is looking forward to getting back to the farm, where he and his wife, Shirley, graze stock on their 18ha property. “It was the best $86,000 I have ever spent.”

The interventional cardiologists who performed the mitral clip insertion were Dr Rajesh Nair, Dr Sanjeevan Pasupati and Dr Gerard Devlin. Imaging of the mitral clip using cardiac ultrasound is crucial for successful outcomes and was led by Dr Mark Davis, Dr Pranesh Jogia and Dr Raewyn Fisher. Mr Adam El-Gamel provided cardiac surgery support and Dr Brian Chan led cardiac anaesthesia. Kath Phillips and Jane Manson co-ordinated the cardiac nursing support. MCVS wish to thank Braemar Hospital for their support and use of their facilities and Southern Cross Hospital Hamilton and GE Health Care for providing imaging equipment and Abbot Vascular (MitraClip device) without whom these procedures would not have been possible.

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