Scaffolding for the heart

Heart doctors in South Africa can now repair arteries with expanding "scaffolding" - tubes that dissolve within two years.

The scaffolding is similar to a stent, a metal tube inserted to open clogged arteries, but has the big advantage of being biodegradable.

Indian cardiologist Ashok Seth, who helped develop the new technology, yesterday used the tubes in surgery with local cardiologist Joe McKibbin, at the Sunninghill Hospital, Johannesburg.

Journalists watched the operation as Graham Cassel, the first South African doctor to undertake the procedure eight months ago, explained what was happening.

Cassel said that though stents - metal tubes 3mm to 4mm in diameter, have "tremendous value" and will continue to be used for years to come, they remain in the heart for life.

The biodegradable scaffolding offers doctors and patients another method with which to restore adequate circulation through blocked arteries.

Seth said: "If you break your leg, it needs a cast on it for only six weeks. Heart doctors wondered why a "cast" to fix the artery had to stay inside for life."

The scaffolding is made of polymers that will dissolve in place within two years. By that time, the clogged artery has been restored to health, he said.

The tiny 3.6mm scaffold is placed in the artery through the patient's groin using key-hole surgery.

The scaffolding includes a balloon that doctors inflate to push open a blocked artery. They watch the process on an X-ray monitor that magnifies the heart and artery.

The pressure used to inflate the scaffolding is about 18 times that used for car tyres, said cardiologist McKibben.

"It is very rare that the artery bursts," he said.

The 69-year-old patient operated on yesterday had all the risk factors for a heart attack. She smokes, is overweight and has high blood pressure, high cholesterol and diabetes.

"The patient had a full-house," said Cassel.

A big benefit of the new procedure is that it obviates the need for patients to take blood-thinning medication for the rest of their life.

The results are "incredibly good", said Cassel.

The patient was expected to go home today, after spending a night in hospital.

A daughter of the patient said that watching her mother undergo the procedure was "scary and exciting" at the same time. She was delighted that everything went well.