A little over two years ago back in 2020, Gerald Ross Greyvenstein, who is 60 years young, started experiencing shortness of breath due to a leaking heart valve. According to Dr James Douglas Aitchison, consultant cardiothoracic surgeon at King’s College Hospital London Dubai and one of Gerald’s doctors, a leaking heart valve is a condition that develops when an individual’s heart valves don’t close tightly enough.
The shortness of breath he was experiencing, explains Gerald, led him to undergo a procedure known as mitral valve repair, which is the standard treatment for mitral valve prolapse, at a different hospital. “Initially, I felt better, but my breathlessness came back a year and a half later, along with abdominal pain and swollen ankles.” This time round, Gerald was referred to Dr Omar Hallak, consultant cardiologist at King’s Dubai, where he was treated conservatively with medication to improve his breathing and reduce the swelling by controlling his heart failure.
“The investigations unfortunately showed that another heart valve -the tricuspid valve – was also leaking severely, due to progression of the heart failure, leading him to undergo a tricuspid valve repair surgery, which happened to be the first cardiothoracic surgical procedure at King’s Dubai,” says Dr Trevor Malcolm Fayers, consultant cardiac surgeon, and Gerald’s primary surgeon at King’s.
“Mitral valve prolapse, which Gerald had suffered from back in 2020, occurs when some of the tissue strands (like tendons) supporting the leaflets making up the mitral valve have snapped,” explains Dr Trevor, adding that the affected part of the leaflet is forced inside out by the beating of the heart, like a sail when the sheet is let go, therefore allowing the blood to leak backwards towards the lungs. “If this is left untreated for long, parts of the heart can stretch, making the heart failure worse.”
The pressure of the blood through the leaking valve, continues Dr Trevor, affects the lungs making the patient feel short of breath and can in time also damage the tricuspid valve on the other side of the lungs, which is what happened to Gerald before consulting with the cardiologists and cardiothoracic specialists at King’s Dubai.
“When the tricuspid valve fails leading to heart failure, this causes the blood to get trapped in the body, in turn causing ankle swelling and eventually abdominal problems,” states Dr Trevor, adding: "Although conservative medical treatment can make breathing better, surgery is likely to be needed to correct the leak. The loose leaflet edge is reconnected to the supporting structures and the opening around the valve is reduced with an artificial ring. This restores the opening to the size that the functioning leaflets can close."
Following Gerald’s cardiac surgery – the re-do operation to fix the second valve - which took place earlier this year, since then he has made great progress. “I have lost 7 kgs of fluid and I must say that this experience and recovery have been so much better than the first operation,” remarks Gerald.
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