NTUH offers safer surgery for heart patients with reduced recovery time

Taipei, Aug. 12 (CNA) National Taiwan University Hospital (NTUH) successfully performed its 100th keyhole surgery recently treating congenital heart disease more safely and requiring less recovery time by replacing a pulmonary valve with a self-expandable valve, the hospital said Monday.

One out of every 3,000 to 4,000 new births in Taiwan suffers from Tetralogy of Fallot (TOF), a congenital heart defect made up of four abnormalities of the heart and its vessels, said Wang Jou-kou (王主科), a clinical professor at the College of Medicine at National Taiwan University, at a press conference.

Those abnormalities include pulmonary stenosis, a narrowing of the pulmonary valve and main pulmonary artery, and ventricular hypertrophy, a condition of the muscular wall of the right ventricle being thicker than normal, according to the United States's Centers for Disease Control and Prevention.

After undergoing surgeries in childhood to correct the abnormalities, around 30 percent of TOF patients develop pulmonary valve regurgitation when they reach adulthood, where the pulmonary valve fails to close completely and allows blood to leak back into the heart, Wang said.

As a result of pulmonary valve regurgitation, the right ventricle also gradually enlarges, eventually requiring a valve replacement, Wang added.

Surgical Pulmonary Valve Replacement (SPVR) is the traditional cardiac surgery to replace the pulmonary valve and typically requires seven to 10 days of recovery, said Lin Ming-tai (林銘泰), deputy chair of NTUH's Department of Pediatrics.

By comparison, Transcatheter Pulmonary Valve Replacement (TPVR), a less-invasive alternative, carries less risk and reduces the recovery time to just one day, Lin added.

Featuring a self-expandable valve delivered to the heart through a small incision in the lower body, TPVR has been available to NTUH patients needing pulmonary valve replacement since 2015 and has been covered by National Health Insurance since Dec. 1, 2021, according to the NTUH team.

As of Monday, the NTUH team, which was designated as Taiwan's sole guidance team for the TPVR procedure in 2021, has performed 102 such surgeries, with 100 of them successful, Lin added.

The 100th case, a 28-year-old TOF patient surnamed Chang, shared her experience before undergoing TPVR in July, saying she would get out of breath easily just from walking or standing and felt fatigued all the time.

"My life now is actually completely normal," Chang said after the keyhole surgery, adding she can walk and climb stairs without feeling tired.

With extensive experience in performing TPVR, some NTUH doctors have been invited to the Philippines to treat patients with pulmonary valve issues, while hospitals in Indonesia and Vietnam have sent doctors to NTUH for relevant training, Lin told CNA.

"They (Indonesian and Vietnamese doctors) observed how smoothly we are able to replace the valves and realized that their patients could also benefit from this treatment," Lin said.

He noted that there will be opportunities for the NTUH team to perform TPVR in Vietnam and Indonesia in the near future.