June 11, 2009
She got her heart reshaped
Housewife Surayah Idris took a leap of faith and tried a new method of remodelling her failing heart. POON CHIAN HUI finds out about the Ferazzi procedure
When multiple heart attacks in January left houswife Surayah Idris, 50, dangerously ill, doctors here had to make a quick decision.
Should they take a chance, after weighing the pros and cons, and perform a new procedure that has emerged only a few weeks ago?
The new method of reshaping abnormal heart structure caused by heart failure, called the Ferrazzi procedure, was devised by Italian surgeon Paolo Ferrazzi and published earlier in January.
'Her heart was functioning at only 15 per cent by then,' said Assistant Professor Theodoros Kofidis, a cardiothoracic surgeon at the National Heart Centre. 'If nothing was done, the next heart attack might kill her.'
This is because some of the muscles in the wall of her left heart chamber had died and had thinned, resulting in a condition called eccentric ballooning, he said.
Known also as an aneurysm, it refers to the balloon-like bulge that forms when the wall of dead heart muscles thins like wallpaper.
When the heart becomes out of shape, it ceases to function normally and may not be able to pump blood efficiently, said Prof Kofidis. 'This condition can cause shortness of breath and the person may not be able to perform everyday tasks well,' he said.
Unfortunately, it was not the only problem that Prof Kofidis had to fix. Scans revealed that Madam Surayah, who was hospitalised at the National University Hospital, had a hole in her heart - one of the most feared complications from a heart attack - as well as blocked coronary arteries.
Both problems can be fixed with relatively good results if they occur on their own. However, the success rate becomes more uncertain for a combined operation coupled with the Ferrazzi procedure.
'Because of the multiple complications, there was a significant chance she would not make it,' said Prof Kofidis.
Told about these odds, Madam Surayah, who is fearful of invasive surgery, nevertheless chose to go ahead with her family's support.
Her husband, MrMasban Masood, 50, a teacher, said: 'I told my children before the operation to be prepared for the worst.' The couple have two children, a 26-year-old daughter, who is a marketing executive, and an 18-year-old son, who is in national service.
In the landmark three-hour surgery on Feb 16, Prof Kofidis performed open-heart surgery to close the hole and three bypasses to clear the blocked arteries on top of the new reshaping procedure.
The Ferazzi procedure differs from its predecessor, the Dor procedure, which requires the insertion of a plastic patch to fix the aneurysm.
The Ferrazzi procedure does not make use of foreign material which makes it much safer, said Prof Kofidis.
Blood loss and risk of infection are also reduced. In addition, the heart is returned to its natural oval shape - unlike the Dor procedure which results in a spherical heart.
Hence, the heart will be able to beat much better, he added.
'I see the Ferrazzi as an evolution of the Dor procedure that gives better recovery,' he said. 'It is, at present, the most natural reshaping technique for patients with an eccentric heart aneurysm.'
Prof Kofidis hopes that Madam Surayah's landmark operation here will inspire more heart failure patients to consider the Ferazzi procedure so that they can recover better. He estimates that there are at least 100 people in Singapore who can benefit from it annually.
As for Madam Surayah, the effects were seen almost immediately. Two days after the operation, she was able to walk without support and a week later, she was discharged from hospital.
'It was a very scary experience because I never knew that I had a heart problem,' she said, adding that she treasures her family ties more than ever. 'I felt as if I had died and woken up again.'