Six months - that was how much time doctors predicted Mr Hassan Doll had left to live.

That was in March when Mr Hassan, 59, was completely bedridden and his heart and lungs were giving up on him.

Today, he is scooting around on his motorbike and working part-time as a car jockey.

The 59-year-old father of four has been given a new lease of life after undergoing aortic valve replacement surgery in the National Heart Centre Singapore's (NHCS) new hybrid operating theatre (OT).

In March, his heart function was down to 15 per cent (normal is 55 to 60 per cent) and his lung function was a quarter that of normal lungs.

To help him tide over the period of time until doctors could operate on him, Dr Paul Chiam put a stent into his aorta in April.

A part of Mr Hassan's aorta was clogged and causing his heart to fail.

But doctors knew this was a temporary solution as all patients would eventually suffer a clog within a year of having the stent put in, said Dr Chiam, consultant cardiologist at NHCS.

(A stent is a man-made tube inserted into a passage in the body such as the artery or aorta to prevent flow constriction.)

New lab, new possibilities

Mr Hassan needed a permanent solution in the form of an aortic valve replacement. But he was too ill to undergo open-heart surgery.

Fortunately for him, NHCS had been offering minimally invasive aortic valve replacement surgery for patients since February.

But the seven patients before Mr Hassan had their surgery done in a separate cardiac-angiography (heart imaging) laboratory where procedures such as ballooning and stenting are carried out on heart patients.

The lab has imaging equipment which is needed for such procedures but is not a fully-equipped operating theatre.

If anything were to go wrong during the ballooning or stenting procedures, the patient would have to be quickly sent to an operating theatre.

"It's a process that takes at least 20 minutes during which the patient may die," said Dr Chiam.

On 1 Oct, Mr Hassan became the first person to undergo minimally invasive aortic valve replacement in NHCS's hybrid OT.

Safer for patient

The OT, operational since August, has high-end imaging equipment and is also a fully-equipped OT. 
Said Dr Victor Chao, consultant heart surgeon at NHCS: "It's much safer for the patient.

"If anything were to happen, such as us having to open up the patient's chest, we don't have to move the patient from the lab to the OT."

The hybrid OT allowed doctors to operate on Mr Hassan easily and safely, he said.

The surgical air flow and filtration systems of the OT also help to provide a clean environment for surgery.

Doctors expect this to improve the wound infection rates.

Said Dr Chiam: "The increased safety factor for patients is important. They can also cut down their costs as the minimally invasive surgery means they need to spend fewer days in hospital."

Patients can save up to 50 per cent of costs, said doctors.

Mr Hassan went home five days after his operation, compared to staying one or two weeks in hospital after open-heart surgery.

A week after returning home, Mr Hassan was up and about on his scooter and going to work.

He said: "I can now walk the distance of three to four bus-stops slowly, without getting breathless. I can also walk up three flights of stairs. It's a great improvement from before."

After the operation, his heart function is now 38 per cent, up from 15 per cent.

Said Dr Chiam: "Now his life span depends on his lungs, which are still damaged by chronic obstructive pulmonary disease caused by smoking."

The hybrid OT is also used by patients who might need both ballooning procedure as well as heart bypass surgery.

Demand to increase

Previously, such a patient would have been sent to the cardio-angiography lab for ballooning, wait several weeks, then go to the OT for bypass surgery.

Said Dr Chao: "Now such a patient does not have to return to hospital twice for both operations. He can get it all done at one time in the hybrid OT. This will save patients time and money."

Doctors expect that 50 to 100 patients will use the hybrid OT - which cost $2 million to set up - in the next year.

But Dr Chao and Dr Chiam also expect that demand for the OT will increase with time as the population ages.

Because his surgery did not have any complications, Mr Hassan's hospital bill was $4,000 which was paid through his Medisave and MediShield.

Source: The New Paper© Singapore Press Holdings Limited. Permission required for reproduction