Cleveland Clinic Abu Dhabi Surgeons Perform Rare Heart Valve Surgery

Young Egyptian patient visiting the UAE has all four heart valves replaced after suffering from acute infective endocarditis

​Surgeons at Cleveland Clinic Abu Dhabi have performed one of the world’s rarest heart surgeries, replacing all four heart valves in a 22-year-old Egyptian patient suffering from acute infective endocarditis that was caused by an infected tooth.

The quadruple valve replacement surgery has been performed on fewer than 20 patients worldwide, according to medical literature.

 Surgeons at Cleveland Clinic Abu Dhabi have performed one of the world’s rarest heart surgeries, replacing all four heart valves in a 22-year-old Egyptian patient suffering from acute infective endocarditis that was caused by an infected tooth.

The quadruple valve replacement surgery has been performed on fewer than 20 patients worldwide, according to medical literature. 

The high-risk, four-hour surgery, in which the patient’s heart valves were replaced with tissue valves, was performed by a team of surgeons, including Dr. Rakesh Suri, CEO of Cleveland Clinic Abu Dhabi, and Dr. Gurjyot Bajwa, a staff physician in cardiac surgery in the hospital’s Heart, Vascular & Thoracic Institute.

“These types of surgeries are very rare,” said Dr. Suri. “There are only a few heart centers in the world that are equipped with the cutting-edge technology, sophisticated therapies and specialist physicians capable not only of doing the surgery but preparing the patient for the operation and getting him through the post-operative course. Cleveland Clinic Abu Dhabi is one of the few hospitals in the Middle East that can offer this type of surgery.”

Infective endocarditis is caused when bacteria enters a patient’s blood stream via a remote infection and attaches to the heart valves. While rare, the infection can be caused by something as simple as getting your teeth cleaned or by a tooth abscess. Symptoms of infective endocarditis include chest pain, shortness of breath, dizziness, a high fever, cough and extreme fatigue.

There are four valves, one for each chamber of the human heart. The tricuspid and pulmonary valves are located on the right side of the heart, while the mitral and aortic valves are on the left. Their role is to keep blood moving through the heart in the right direction.

The patient became sick in December last year after having an infected tooth removed. His condition quickly deteriorated and doctors in Dubai diagnosed him with pneumonia. However, the infection rapidly spread throughout his body, attaching itself to all four heart valves and severely damaging them.

In January, he was transferred to Cleveland Clinic Abu Dhabi, part of Mubadala’s network of healthcare providers, where a multidisciplinary team of heart surgeons, cardiologists, imaging specialists and other caregivers decided to proceed with the surgery despite the low survival rate.

“We studied his condition among a multidisciplinary team and told him that this was a high-risk operation,” said Dr. Bajwa. “However, without it, he would not have survived. Positive factors included the fact that the patient did not have any immune-compromising disabilities and no history of heart disease, and he has since recovered extremely well.

“During the open-heart surgery, the patient was placed on a heart-lung bypass machine and his heart was stopped for only 70 minutes. We began with the valves on the left side of the heart: the aortic and mitral valves. We quickly removed them and replaced them with the tissue valves,” she added.  

“We then replaced the pulmonary valve, on the right side of the heart, and then moved on to the final valve, the tricuspid. It was a time critical, efficiently run operation – and that was the key to getting him off the table alive,” concluded Dr. Bajwa.

Dr. Mahmoud Traina, a cardiologist in the Heart, Vascular & Thoracic Institute at Cleveland Clinic Abu Dhabi, said the patient was recovering very well.

“The patient is making an impressive recovery and his spirits are amazingly good considering what he has been through,” Dr. Traina said. “He has been discharged from Cleveland Clinic Abu Dhabi and we are continuing with our follow-up care.”

The hospital’s Emergency Medicine Institute is a designated Chest Pain Center for Abu Dhabi, providing medical care for all patients with chest pain who arrive in the emergency room. 

“I have received extraordinary care at Cleveland Clinic Abu Dhabi and thank the doctors for saving my life,” the patient said. “My family is very happy that my surgery went well, and I plan to return home as soon as I can.”

Cleveland Clinic Abu Dhabi’s Heart, Vascular & Thoracic Institute​ is one of the hospital’s five Centers of Excellence. Led by some of the world’s most experienced and respected physicians and surgeons, its Heart Valve Disease Program offers cutting-edge methods for diagnosis and treatment of patients.