11/08/2009
FEATURED IN THE DAILY EXPRESS
MY HEART STRINGS ARE MADE FROM GORE-TEX
Graham Harrison had the waterproof fabric sewn into his heart to fix a faulty valve. He talks to TIM BRADY.
If you needed a life-saving implant to stop
your heart from packing up, the last place you might look is your
wardrobe. Yet that’s exactly where the material used to fix Graham
Harrison’s defective heart is normally found.
Graham,
32, is one of only a handful of patients in the UK to have had tiny
strips of Gore-Tex sewn into his heart to fix a faulty valve.
Gore-Tex, launched in 1978, is the waterproof,
breathable fabric best known for use in outdoor wear. It has found its
way into a range of medical uses, from heart surgery to lip
augmentation. Its flexibility and porous structure make it ideal for
use inside the body.
Graham,
from Guildford in Surrey, underwent surgery to replace missing heart
strings, tiny cord-like tendons that open and close a valve in the
right side of his heart that were damaged at birth.
“Gore-Tex
is perfect because it’s very elastic and has a honeycomb structure to
it,” says Graham’s surgeon Neil Moat, from the Surrey Cardiovascular
Clinic in Guildford.
“In effect, it provides a kind of scaffold that allows the patient’s own cells to grow in and around it.”
Graham,
a stage manager with the hit musical Joseph And The Amazing Technicolor
Dreamcoat at London’s Adelphi Theatre, was diagnosed with a faulty
tricuspid valve shortly after being born.
Doctors blamed a traumatic labour lasting 28 hours. As soon as he was born staff noticed his heart was beating irregularly.
The
tricuspid valve separates the two big chambers on the heart’s
right-hand side, the right atrium and directly under it the right
ventricle.
Blood passes from the atrium into the ventricle through the tricuspid valve, before being pumped out towards the lungs.
In a healthy body the tricuspid valve snaps shut
to stop blood flowing back up through it and into the atrium again. A
defective valve can allow blood to leak back up, a problem called
regurgitation.
Some
people, like Graham, are born with defective valves. Others can develop
problems as a result of conditions such as rheumatic fever.
Holding
the valve in place is the job of tiny heart strings, called chordae
tendinae. These operate much like the strings on a parachute, pulling
tightly on the three flaps that make up the tricuspid valve.
If these strings are missing or not working properly, the heart struggles to pump blood efficiently.
Eventually this can result in chronic heart
failure, where the body’s major organ is so worn out that, in many
cases, it needs replacing with a transplant.
Most
children born with Graham’s condition need major treatment, such as
surgery, long before they reach adulthood. This often involves
replacing the whole valve with a man-made substitute.
One
of the major downsides is that patients must take the blood-thinning
drug warfarin for the rest of their lives because of a significant risk
of clots forming around the replacement valve.
Although
warfarin is very effective it can increase the risk of internal
bleeding and must be monitored very closely. For many years it was best
known for its use as a rat killer.
If
possible, surgeons prefer to repair the existing valve. Yet it’s
estimated that only around half of defective valves are repaired rather
than replaced.
Mr Moat
and his team at the Surrey Cardiovascular Clinic, in close
collaboration with London’s Royal Brompton Hospital, run one of the few
services in the country specialising in valve repair.
“In terms of heart function, we know a repair is much better than a replacement,” he says.
“Yet many people just do not get referred to a surgeon who specialises in it.”
Most
sufferers need surgery fairly early in life. Amazingly, however, Graham
suffered no major symptoms until about three years ago.
“My
heart rate would double or treble when I was just sitting watching
television. Then I started to get shooting pains down my left arm and
into my head. I didn’t really understand what was going on and was
scared that my heart was packing up.
“A couple of times I passed out and was admitted to hospital for the night. I was usually just sent home the next day.”
By
late 2006 Graham’s health was deteriorating rapidly. Doctors explained
the options, including implanting a substitute valve. However, the need
to constantly monitor his warfarin use did not fit in with Graham’s
busy work schedule.
Instead, he opted to have the Gore-Tex repair. As with all major surgery, there was a risk he would not survive the procedure.
“I wrote my will when I was just 29,” says Graham, who is single.
“We also had a family gathering on the day before I went in to hospital. I think it was harder for them than it was for me.”
During
the three-hour operation at the Royal Brompton Hospital, Mr Moat
attached the tiny strands of Gore-Tex to the damaged valve.
“Gore-Tex is good because it has a little bit of spring in it,” he says.
Graham
was heavily dosed up on painkillers during his eight days in hospital.
He made a rapid recovery but has been left with a nine-inch scar on his
chest.
“I was up on my feet within two days and back at work after four months,” he says.
“I recovered incredibly quickly and I’m pretty active all the time.
“My heart doesn’t seem to misbehave at all now and my six-monthly checks have gone down to yearly ones.
“My condition was definitely life-threatening but now I’m busy living life to the full.”
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