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Surgeons at Cleveland Clinic Abu Dhabi, part of the Mubadala network of healthcare assets, have successfully performed a minimally invasive procedure to repair a leaky heart valve in a high-risk patient, collaborating with experts through live steaming technology.
In March, the 67-year-old patient (name withheld) presented to Cleveland Clinic Abu Dhabi with pulmonary edema – an abnormal buildup of fluid in the lungs – caused by congestive heart failure. After a complete evaluation of their medical history, the multidisciplinary care team at the hospital concluded that a leaky mitral valve in the heart had to be repaired immediately using a small medical metal clip. The clip would prevent blood flowing backward into the heart, known as mitral valve regurgitation.
Dr. Mahmoud Traina, an interventional cardiologist at the Heart, Vascular & Thoracic Institute at Cleveland Clinic Abu Dhabi, says that they decided to perform a minimally invasive transcatheter procedure because the patient was not a suitable candidate for standard open-heart surgery due to their comorbidities, including blocked arteries and lung disease.
“As global best practice, surgeons are always accompanied by a technical expert from the company that designs the mitral clips in the operating room. The expert provides technical support during the procedure and helps our prep staff understand any new iterations of the device. The expert’s assistance ensures that we achieve the optimum result for our patient.”
On this occasion, Dr. Traina says, the hospital was unable to host the expert in person due to visitor restrictions given the COVID-19 pandemic.
“We did not want to delay the treatment because of this as the patient’s health would continue to deteriorate without the life-saving procedure. So, we had to innovate with technology,” says Dr. Traina.
The medical team – which included cardiologists, cardiac surgeons, anesthesiologists, operating room consultants and the nursing team – in collaboration with Cleveland Clinic Abu Dhabi’s IT department organized an elaborate live streaming set-up to connect with the technical expert in real-time during the operation.
“Along with live streaming, we also had high-definition cameras directed to the procedural area for the technical expert to be able to see a detailed view of the operative field. The team was also relaying primary data, including the ultrasound videos and x-ray images, giving real-time ‘in-the-room’ visualization of the surgery. This teleproctoring technique was seamless and the first of its kind globally for such a procedure. The patient is now home and their recovery is on track.” says Dr. Traina.
“Our positive experience with this patient opens up a host of opportunities for further collaborations to treat complex and critical cases and live demonstrations for trainee education.”
The patient says that initial concerns about getting infected with the virus during their time at the hospital were put to rest after discussions with the care team at Cleveland Clinic Abu Dhabi.
“I was worried and asked the doctor if we can postpone the surgery until the situation got better, but they were very reassuring and explained that the team was fully prepared to do this minimally invasive procedure with the highest safety standards in place.”
Dr. Traina adds that the hospital follows a rigorous protocol, based on international standards, to ensure that patients with surgical emergencies are safe during the COVID-19 pandemic.
“The fundamental question that the medical team has to ask is whether this surgery can wait and what is the risk of waiting. In this case, we wanted to prevent the patient’s health from deteriorating further.
The patient says they are happy with the results of the operation and their heart is “doing very well.”
“The doctor has asked me to be careful at home and self-isolate as much as possible while I recover. I have been advised to wear a mask and gloves whenever I go out and take good care of my nutrition. The entire care team at Cleveland Clinic Abu Dhabi has been very attentive and I’m so grateful for their support.”
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