José Ignacio Sáez de Ibarra He has been successfully repairing ‘doors’ for almost 25 years … in the operating room. 5,000 hearts have passed through their hands with (‘doors’) insufficient valves that did not close well and that could be fixed. “When it does not close well, the easiest thing is to change it for a new one,” the head of cardiac surgery of the Son Espases de Palma explains to ABC, comparing the simple mechanism of a door with cardiac surgery.
But he and his team They have specialized on the contrary: keep the doorcarve it and leave it working. “It is the native valve in your heart, it is integrated into that heart and it is the best door to be there,” argues the renowned cardiac surgeon, which has just received, along with his team, an ‘Óscar’ by two complex surgeries of hearts from heart .
The Ministry of Health has recognized the cardiac surgery service of this Mallorcan hospital as a National Reference Center (CSUR) in the complex repair heart surgery of the mitral valve and the conservative surgery of the aortic valve. Both allow to restore the correct functioning of the valves and conserve them instead of replacing them. “If you do not close well, the hinges, the lock and, generally, the frame, which by force of blows is broken or disagree is adjusted,” continues the cardiovascular surgeon using the same simile to make the complex intervention that four hospitals in Spain. “Currently they only have the accreditation of CSUR El Gregorio Marañón in Madrid, the San Carlos Clinic of Madrid, the Clinic of Barcelona and -Now- Son Espases.”
Most Spanish cardiac surgery services dominate repair techniques, but when there is an affectation of the previous valve, or both valves – as in Barlow syndrome or in rheumatic valvulopathy – mitral repair or valve conservation Aortic requires more experience and are carried out only in centers with adequate training. Son Espases is one of them and can operate patients from all over Spain in these two interventions.
«Patient survival is good If the patient operates in an early phase and if the ventricle has not been affected. In that case, he has a life expectancy close to a healthy person, ”says Sáez de Ibarra, who is already beginning to have re -exploratory patients for more than 20 years ago. “They are still alive and the reoperes is something beautiful,” he acknowledges.
To carry out these interventions in a correct way, previously a complete and multidisciplinary study is carried out to assess the etiology, mechanism and repair possibilities. Clinical, echocardiographist and cardiac surgeons participate. “According to the pathology, one technique or another adapts so that the valve maintains the maximum tissue of the patient.”
The patient profile that reaches your consultation is people from 45 to 65 years“Although there are also many older with 75 or 80 years.” The debate in this case is how far to go: “The issue is not whether we can do it and do well but not to do in excess.” However, he acknowledges that «today Be 80 or 84 years is not a limitation to operatewhich was 30 years ago ».
The consultations come more and more endocarditis, which is the inflammation of a heart valve. «This happens because more and more tests are performed and patients are instrumentalized. Every time they are going to make a TAC they put a peripheral route, they are punctures that we put and the sera are spotlights of entry of bugs in the blood and some stay in the heart. That is an important health problem due to the increase in evidence, ”.
Sáez de Ibarra arrived in Mallorca by chance almost a quarter of a century ago. He had formed in Paris, where he worked with the most leading services in Europe in valvular repair. Later he was working for two years in Canada, where he received an award for his work. In 2002 he was determined to go to Barcelona, but the doctor he had to replace did not leave. Then, the prestigious cardiac surgeon Oriol Bonnín called
Cardiac transplantation, the challenge
They set up the service from zero between four. It was “hard” but “a beautiful story” because it allowed to participate in the design of the service, led by Dr. Bonnín, and grow until today becoming one of the references of the whole country in cardiac surgery. In 2003 they organized the first valvular repair course with live surgery in Son Dureta. They did school forming people and disseminating the technique. Their boss always instilled in them the quality of results and respect for the patient. They passed ten or fifteen years until they moved to the Son Espase hospital, “which meant another leap of quality for the Balearic health.”
They launched the ventricular assistance program, which has allowed, for example, keeping young people with a heart attack in life whose heart does not resist. “That has been very important while we make a decision of where to go,” he emphasizes, and they consider putting a definitive machine, an artificial heart, or a heart transplant.
His hope would now be Being able to open a heart transplant program at the hospitalsince currently between 10 and 15 patients a year they have to go to the Peninsula to receive a heart. «It would be the last challenge. But you have to put many people agree, ”he sighs.
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