‘No more scars’
Revolutionary cardiac procedure reduces need for open-heart surgery at UHWI
Published:Sunday | January 5, 2025 | 12:07 AMErica Virtue - Senior Gleaner Writer
Open-heart surgery, intensive care admission, and extended hospital stays are now a thing of the past for many cardiac patients at the University Hospital of the West Indies (UHWI), as the risks and complications once associated with some procedures have been significantly reduced.
Dr Tahira Redwood is leading the charge in this cutting-edge area of treatment, which involves keyhole incisions and accessing the heart through the legs instead of opening the chest to carry out procedures such as inserting a new heart valve.
She explained that many patients undergoing this procedure do not require intubation; instead, they are heavily sedated and, according to her, are often on their feet within two days.
“My surgery is perfect because it’s a very low risk,” she told The Sunday Gleaner. “It doesn’t matter what illness you have, generally, my surgery is pretty safe and the risk of anything bad happening is very low, versus if we were to do open-heart surgery.”
Redwood, who specialises in general cardiology, further trained in coronary intervention for heart attacks. Her expertise includes treating blockages by inserting “a special device to open up that blockage to make sure that the blood can flow down to the heart muscle”.
She did further specialisation in structural heart disease to fix heart valves and adult congenital to address heart defects such as holes in the heart or abnormal connections.
In the Caribbean, she stands as the only professional with all of these qualifications combined.
“Open-heart surgery requires much deeper sedation. The patient has to be intubated and put to sleep, which is different from my procedure. ... You’d have to do an incision and cut the breast bone, cut the rib cage open so that they could access the heart,” she said.
“We don’t have to do [any of that with this procedure]. You don’t have any scars or anything. We don’t have to put the rib cage back together. We just go through the leg vein or artery and we can put the valve through that. So by the time you come out, you won’t even know you had a procedure. You just feel so much better and you have a new heart valve,” she told The Sunday Gleaner.
Both surgery time and recovery time have been significantly reduced.
“The average time for a heart valve to be changed is about two hours. That is with the sedation from our anaesthetist, to putting in a valve, to waking up and being able to eat. Two hours. That’s why it is so amazing,” Redwood said.
CALCIFICATION
She explained that with older individuals, heart valves can become calcified (hardened), which leads to a narrowing of the valves. In some cases, it causes a “leak”, so blood flows backward instead of forward, resulting in symptoms such as chest pain, fainting, and heart failure – particularly in patients over 65.
The procedure is one of several being done in the multipurpose interventional suite at the UHWI, which has been facilitating a number of first-in-the-region surgeries at the island’s teaching hospital.
Regarding costs, Redwood mentioned that the devices used are “very costly”, adding that despite the hospital’s best efforts to minimise the expense, it remains expensive for the average person. The UHWI, however, has been covering the cost of the procedure for patients over 65.
“Our population is ageing and we have more and more patients presenting with heart disease, and ... heart disease is the leading cause of death in Jamaica and the Caribbean, so it’s a very needed procedure. Without health insurance, it is difficult for patients, but once we’re able to cover the cost, we do it for all the patients over 65 years,” she indicated.
The cost of an average heart valve is US$14,000 (approximately J$2.17 million), and the patients must purchase the valves themselves. However, the cost may vary depending on the size of the valves, as multiple investigations are carried out before determining the correct one.
“If you’re in the US (United States) or in the UK (United Kingdom), this is the procedure you’ll be getting over open-heart surgery. Unless we could not put in a valve, then this is the procedure you’d be getting. It’s short, it’s quick, it’s very technical, it’s a very complex, but we’ve done it many, many times,” said Redwood.
After the procedure, patients are transferred back to the wards, where regular cardiac monitoring is used to demonstrate the safety of the surgery. Most patients are able to get up the same day and can return to regular activities within one or two weeks. No physiotherapy is required, apart from the usual cardiac rehabilitation for individuals with heart disease.
Redwood has also been invited to perform surgeries in other countries, including Guyana, and noted that territories such as The Bahamas and the Turks and Caicos Islands have sent patients to Jamaica.
“We have to try to make it affordable for Jamaican people, as it is clearly more affordable for the rest of the Caribbean, and, of course, we have a 100 per cent success rate in our procedures,” she stated.
NEED TO ACT QUICKLY
While no one can predict who will experience a heart attack, Redwood advised that symptoms such as light-headedness, chest pains, shortness of breath, swelling in the legs, difficulty breathing, and discomfort when lying down should prompt an immediate visit to a cardiologist.
She cautioned against waiting to see if the symptoms resolve on their own.
“The longer you take to fix a bad heart disease, the more expensive it is, the harder it is, and the more damage to your heart in the long term, and the more medication you’re going to need in the long term,” she warned. “If you have chest pain, do not watch it to see how it feels and then show up at 2 a.m. because you can’t sleep. As soon as you feel the chest pain, you need to come and check it out.”