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Doctors and close relatives of patient watch mitral valve repair on a screen
View(s):- Keyhole heart surgery
By Kumudini Hettiarachchi
The scene on the fifth floor of the Sri Jayewardenepura General Hospital (SJGH) is surreal – it is Saturday, July 26th and glued to several TV screens are all those doctors who hold people’s precious hearts in their hands.
On the screens are close-up ‘live’ images of keyhole (minimally-invasive) heart surgery being performed by our very own Consultant Cardiothoracic Surgeon, Dr. Rajitha Y. de Silva, joined by India’s Dr. Sathiyaki Nambala who leads the cardiac surgery unit at Bangalore’s Apollo Hospitals.
Heart surgeons watching the procedure on the screen. Pix by Priyanka Samarawickrama
Different levels of Sri Lankan heart doctors, from the topmost Consultant Cardiothoracic Surgeons, coming down the line to Senior Registrars, Registrars and Medical Officers all hoping to follow the heart surgery speciality are there.
We too are part of the International Minimally-Invasive Cardiac Surgery (MICS) Workshop, looking in wonder at how the heart is being accessed without opening up the chest. Usually, heart surgery is performed by opening up the chest wall with a big cut and sawing of the breast bone (sternum) to expose the diseased heart.
Dr. Rajitha Y. de Silva
The workshop on minimally-invasive aortic valve replacement (AVR) and minimally-invasive mitral valve repair (MVR) is a satellite session of the Annual Scientific Sessions of the Association of Cardiothoracic & Thoracic Surgeons of Sri Lanka (ACTSSL).
Dr. Sathiyaki Nambala
While AVR is to replace the valve that keeps oxygenated blood flowing from the heart into the largest artery in the body (aorta), MVR is the repair of the damaged mitral valve to allow the valve to close fully and stop leaking.The mitral valve which has two tapered cusps (leaflets) is between the left atrium and the left ventricle of the heart.
…….And among the doctors is the mother and aunt (punchi) of the 33-year-old from Polgahawela who is undergoing the minimally-invasive MVR, following with wide curious eyes every action on the screen.
“Thakshanika diyunuwa penawa (Can see the technological advancements),” says the mother, as finally the heart issue of her son is sorted out, the keyhole is closed and the colour echocardiogram shows the working of his heart without a problem.
In minimally-invasive heart surgery, a 4- to 6-centimetre incision is made along the ribs on one side and a tool with a camera on the end (endoscope) inserted to view the site which needs repair. Thereafter, small surgical tools are inserted through another small cut to perform the repair.
Minimally-invasive surgery offers the benefits of faster healing and recovery time; less pain and reduced reliance on pain medication; lower risk of infection or blood loss; reduced scarring; and shorter hospital stays, it is learnt.
Dr. Rajitha de Silva, meanwhile has been a pioneer – introducing ‘hybrid heart surgery’ – a combination of two procedures, sans open-heart surgery in 2016, using the skills of the Cardiologists in the Cardiac Catheterisation Laboratory and the Cardiothoracic Surgeons in the Cardiac Operating Theatre in keyhole surgery.
Close up of the keyhole procedure
Images from within the operating theatre
Dr. de Silva has also operated on the beating heart of patients through minimally-invasive heart surgery as opposed to open-heart surgery which needs the heart-lung machine.
A charitable initiative, he along with Senior Consultant Cardiologist Dr. Ruvan Ekanayaka has launched the Heart to Heart Trust Fund to help impoverished patients across Sri Lanka for whom cardiac surgery is beyond their financial means.
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