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Cardiac Matters

For more information on Cardiac Services at London Bridge Hospital, please contact the GP Liaison Team on:

T: 020 7234 2009

CAsE sTuDy – MR PETERsEN, AGED 77

Mr Petersen was familiar with

London Bridge Hospital’s cardiac care

reputation when he requested to be

referred to our Cardiac Consultants

for treatment.

Following a detailed medical history,

Mr Petersen, 77, was referred to

London Bridge Hospital after tests

indicated he had a mitral valve

weakness. Mr Petersen was initially

referred to Dr Jonathan Hill, a

Consultant Cardiologist specialising

in coronary disease, to undergo a

Coronary Angiogram. As part of the

hospital’s integrated approach to

testing and assessment, Mr Petersen

also saw Professor Mark Monaghan,

Consultant Clinical Scientist, to

undergo further investigations. These

included an echocardiography and 3D

Echo. The objective of the testing was

to establish if and why Mr Petersen

had a predominantly leaking valve, and

in addition, why his heart pumping

function had reduced.

The tests confirmed his coronary

arteries were healthy. However, it was

established he did have a leaking valve,

which could be repaired surgically. Mr

Petersen was subsequently referred

to Mr GrahamVenn, Consultant

Cardiothoracic Surgeon, who

specialises in complex mitral valve

repair. Mr Venn was concerned about

additional potential problems related

to Mr Petersen’s leaking valve.

As a patient at London Bridge

Hospital, Mr Petersen had access to an

extensive team of Cardiac Consultants,

each an expert within their own

cardiac specialty. As such, he was

referred to Dr Gerald Carr-White,

who specialises in valvular heart

disease. Dr Carr-White investigated

whether Mr Petersen’s weakening

heart was due to the leaking valve,

or whether there was another

underlying genetic cardiac problem.

Dr Carr-White also sought to

establish whether repairing or

replacing the valve was the best

approach, and also whether this

was the best time to carry out the

procedure.

Mr Petersen had a clinical review,

and a coronary MRI scan under

Dr Carr-White. The results from his

series of tests determined that, after

his blood was being pumped forwards

from his heart, 40% of that blood

was being pumped back again. This

confirmed that his weakening heart

was due to the leaking valve, and that

he would benefit from surgery.

Mr Petersen was referred back to

Mr GrahamVenn to discuss the

potential surgical options. As with

all cardiac patients at London Bridge

Hospital, Mr Petersen benefited not

only from the specialist care of Mr

Venn, but also his team of surgical

nurses, anaesthetic practitioners and

perfusionists, who helped to facilitate

a complex mitral valve repair instead

of performing valve replacement

surgery. The advantage of performing

a mitral valve repair is that it helps to

preserve and retain the structure of

the valve.

As part of the in-depth assessment

and diagnosis carried out previously,

it had also been determined that

Mr Petersen had Atrial Fibrillation

(AF) – a condition resulting in his

heart running at a higher pace than

usual. Before surgery took place, Mr

Venn worked closely with Professor

Richard Schilling, Consultant

Cardiologist specialising in AF, to

confirm whether during the mitral

valve repair, Mr Petersen should also

undergo ablation for his AF. Professor

Schilling confirmed that having an

ablation would return Mr Petersen’s

heart rate to a normal rhythm,

reducing the risk of him suffering

from a stroke. During the ablation,

Mr Petersen had an AtriClip fixed to

his left atrial appendage (the chamber

that sits before the mitral valve,

which is often where blood clots

accumulate) to reduce the future risk

of blood clots forming.

Following his mitral valve repair and

ablation, Mr Petersen presented

with kidney failure and fluid on

the lungs, both of which can be

common following this procedure.

Fortunately, he was quickly admitted

to the hospital’s on-site Intensive

Care Unit, which provides 24-hour

specialist care for patients requiring

multi-organ support. He spent

a week in intensive care, before

being transferred to the hospital’s

High Dependency Unit while he

recovered. Mr Petersen then had

a further week’s recovery on the

CardiacWard.

Following his treatment at London

Bridge Hospital, Mr Petersen has

made excellent progress. He reports

feeling more energetic, and has been

able to return to the activities he

enjoys. He is now able to work in

his vineyard and play a full round of

golf, walking to all 18 holes without

feeling breathless – something he

would not have been able to do

previously.

Mr Petersen said,“I have been very

lucky – I was surrounded by the

best medical team at London Bridge

Hospital. They are clearly the best

in the business, with state-of-the-art

equipment and facilities.”

If Mr Petersen had not received this

crucial treatment when he did, his

heart would have become weaker

and his leaking valve would have

progressively degenerated. There

is also a chance, if he had left the

operation until a later stage, his body

might not have been able to cope.

Carrying out a complex mitral valve

repair at this precise time resulted in

the operation being 100% successful.

Mr Petersen received support and

treatment from five Consultants

with expertise in a wealth of cardiac

specialties. His team of Consultants

included specialists in coronary

disease, echocardiography, mitral

valve repair, Atrial Fibrillation, cardiac

imaging and valvular heart disease.

Through the hospital’s individualised

patient care plan, each Consultant

and their supporting teams played

a crucial role in Mr Petersen’s

treatment, aiding his diagnosis and

helping him in making a full recovery.

SEVEN

Cardiac Matters