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CAVI Operation done in the Caribbean

An advanced heart procedure called Caval Valve Implantation (CAVI) was successfully performed for the first time in Trinidad and Tobago and the entire Caribbean region with the patient showing promising outcome after six months of medical follow up.

The procedure was done on 30th November 2021 at West Shore Private Hospital, on a patient suffering from severe tricuspid regurgitation––a leaking heart valve condition associated with severe heart failure.

The patient who was so diagnosed had a prior permanent pacemaker implant, with repeated decompensation and prior hospital admissions.

Carrying out the breakthrough surgical procedure was a multidisciplinary specialist Heart Team at Advanced Cardiovascular Institute (ACI) based at West Shore Private Hospital.

The team was led by well-reputed T&T Interventionalist Cardiologist Dr Ronald Henry and included Professor Dr Prashant Vaijyanath, a highly experienced Cardiothoracic surgeon from India who was trained by the manufacturers of the CAVI device; together with anaesthesiologist Dr Sheldon Olton and Cardiothoracic Surgeon Dr Wazir Mohammed.

Tricuspid regurgitation is a condition which causes the blood to flow backwards in the upper chamber of heart (right atrium) when the lower chamber (right ventricle) contracts. This consequently leads to recurrent right heart failure, excessive abdominal swelling, liver congestion, swollen feet, along with digestive problems and chronic fatigue.

The patient was deemed unfit for conventional valve replacement surgery because of multiple comorbidities, and was not getting relief from optimized medications and repeated drainage of excess abdominal fluid. After review, the ACI medical team medical team considered this patient to be an ideal candidate for this revolutionary new procedure.

The CAVI operation involves the implantation of two valves through a small cut in the patient’s upper thigh. The devices are advanced and deployed using catheters and guidewires under X-ray guidance, all conducted in a special procedural room called a Catheterization Laboratory.

In the historic procedure, a superior vena caval valve and an inferior vena caval valve were successfully implanted using the TricValve system from Germany.

The patient was discharged a few days after the procedure and has continued to be followed up post-procedurally. Now six months post-discharge, the patient continues to demonstrate significant improvement in symptoms and requires much less medications.

Commenting on this first-ever Caribbean breakthrough, the Managing Director of ACI

Mr Christopher Camacho pointed out: "This ushers in the history-making era of advanced transcatheter valve technologies in Trinidad and Tobago and the entire Caribbean, as we can now offer hope to many patients suffering from advanced heart valve conditions which previously could not have been treated."

He added: “I congratulate the medical team at ACI for taking yet another quantum leap in local heart care.”

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