Abu Dhabi: Elderly woman is first patient in UAE to benefit from new heart procedure

The approach is considered safer than open heart surgery and allows patients to regain lost quality of life


Ismail Sebugwaawo

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Published: Thu 25 Nov 2021, 12:46 PM

A 77-year-old Emirati woman, who suffered from a tricuspid heart valve, has become the first patient in the UAE to benefit from a new and innovative procedure.

Doctors at the Cleveland Clinic Abu Dhabi treated her condition using a complex, non-surgical procedure. It is also the first time the procedure has been performed in the UAE.

The medics at Cleveland Clinic Abu Dhabi said they spent months working on their imaging capabilities and refining their technique to prepare for the procedure.

Afra, the patient, had spent the last two years in and out of hospitals due to excessive fluid build-up in her legs and internal organs caused by her tricuspid valve regurgitation.

As a result, she was no longer able to live a full and active life. Since undergoing the procedure, her quality of life has improved significantly, and she is looking forward to being able to return to her farm and care for her plants once again.

“I am so thankful to the people that brought this treatment to the UAE, my doctors and Cleveland Clinic Abu Dhabi,” said Afra.

“When Dr Traina told me that the procedure is minimally invasive and is not a major operation, I felt huge relief.”

She added: “The last few years have been hard but I have faith that we are always in good hands. Now I am looking forward to doing the things I love and caring for my small farm here at home.”

How the Tricuspid valve regurgitation occurs

The doctors at Cleveland Clinic Abu Dhabi explained that tricuspid valve regurgitation occurs when the heart valve no longer closes completely when the heart beats.

This allows blood that pumps into the heart to flow back out in the wrong direction, leading to increased pressure that floods the body with excess fluid. This fluid can build up in the body’s tissue, causing swelling in the legs and organs that significantly impacts a patient’s quality of life.

The symptoms caused by tricuspid valve regurgitation can usually be controlled with medication to help the body reduce the build-up of fluid.

However, until recently, patients who did not respond well to medication had no viable options to control their condition as surgery to repair it is extremely high risk. Recent technological advances have meant that physicians at a handful of centres around the world have begun exploring non-surgical methods to restore lost heart valve function.

Dr Mahmoud Traina, an interventional cardiologist at Cleveland Clinic Abu Dhabi, said: “The tricuspid valve is perhaps the hardest of the four valves of the heart to work on - particularly when taking a percutaneous approach.

“The challenge is that the tricuspid valve is significantly harder to see than the mitral valve, for example. Happily, thanks to advances in imaging technology and a tremendous amount of dedication and effort from my colleagues in our cardiovascular imaging section, we are now able to get a good enough view to repair the valve percutaneously (through the skin) - benefiting patients who were previously untreatable.”

Hospital spends month preparing for the procedure

Dr Ahmed Bafadel, director of structural imaging at Cleveland Clinic Abu Dhabi, said: “Over the last few months, we have worked closely with our interventional cardiology team during procedures to improve our focus on this valve and dial in the details to make sure we can see each individual part.

"It took a lot of clinical research to improve our imaging capability, building on a great deal of advances in real time and 3D imaging to make all this possible.”

During the three-hour, minimally invasive procedure, doctors insert a small device that clips onto the flaps that seal the tricuspid valve and ensures they make a strong seal to prevent blood from flowing back through.


This device is inserted through a vein in the patient’s leg and carefully guided to the heart.

Doctors can see what they’re doing thanks to an advanced form of ultrasound and place the device while the heart is still beating. This approach is significantly safer than open heart surgery and allows patients to regain lost quality of life caused by fluid build-up.

“This was certainly one of the hardest procedures I’ve ever done in my career. I am very glad that we have such a remarkable team in place here and a close relationship with our colleagues at Cleveland Clinic in the United States. They’ve done a lot more of these procedures so were able to give us direct guidance during the procedure as well as some tips and tricks that proved invaluable,” said Dr Traina.

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