Good news for heart patients: Doctors at Shaare Zedek Medical Center in Jerusalem recently performed a procedure that was the first of its kind in Israel and one of the few performed in the world, during which the doctors managed to fight an aggressive infection that had developed in the heart, through catheterization, and not through complex heart surgery as is customary.The one who underwent the unique procedure is 35-year-old Rivka Orlev, who has been dealing with lupus and heart problems in recent years. Prof. Danny Dvir, director of the catheterization unit at the medical center, explains that “Rebeka arrived at the hospital in a life-threatening medical condition, suffering from an extremely aggressive bacteria in one of the heart valves, which are responsible for the blood flow in the heart and body.” According to him, the medical team first tried to treat the infection with intensive antibiotic medication, but it was unsuccessful. The remaining option was to remove the bacterial colony on the valve through open heart surgery, but this was also not possible due to her complex medical condition. “The patient had undergone heart surgery in the past, and we were very worried that she would not survive another surgery,” explains the professor.

First procedure of its kind

Following this, the team looked for other ways to treat the infection, and after many discussions, it was decided to perform the first procedure of its kind in Israel, to remove the infectious tumor through catheterization. According to Dvir explains that usually catheterization is used in situations of blockage in the blood vessels or the valve. In such cases, balloons, catheters (stents) or valves are inserted that open the blockage.” “In recent years, catheters have also begun to be used for the purpose of removing blood clots in the blood vessels, which led us to think that the procedure may also be suitable for removing the infection, although until now such problems They needed surgery.”

The professor explains that unlike open heart surgery, when performing a catheterization there is a technical difficulty in removing large findings from the body, since the arteries through which the catheter passes are narrow and only a few millimeters in size. “This challenge requires advanced technologies and specific skills, mainly due to the fact that in catheterization the doctor is based on X-ray and ultrasound imaging only, compared to open heart surgery where you can clearly see the organ that needs treatment.” At the same time, he emphasizes that catheterization is a less invasive procedure, and usually safer than heart surgery, and it allows for an easier recovery.

Shaare Tzedek points out that today it is possible to perform more procedures that until now were limited to surgeries through catheterization, thanks to new developments and advanced equipment, including the greatly improved imaging technology.

The infection was removed from Orlev’s body under the guidance of the director of the echocardiography unit, Prof. Shami Kerso, and within a few days her condition stabilized – and she was released to her home. At the time of discharge, Orlev thanked the medical staff, saying that “these were not easy three weeks. Despite the challenges that arose along the way, you led me to the end of the hospitalization when I am ready to return home to my family.”

Prof. Dvir adds that this operation is an example of dramatic processes that occur in the field of cardiology. “I believe that we will soon see similar procedures in other hospitals, in Israel and abroad. These operations enable a less invasive therapeutic approach to medical conditions that previously did not have a safe and effective solution. Over the years we have seen the trend in other areas as well, for example in the distant past many more abdominal surgeries involving surgical opening were performed, compared to today when there is widespread use of less invasive methods in these surgeries, such as laparoscopy. Little by little this trend permeates other areas as well. The sky is the limit, and as far as future technology allows, almost all heart procedures will be performed by catheterization without opening the chest.”

By Editor

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