First person to get cow heart transplant while wide awake says it’s ‘like Star Wars’


John Smallwood, 74, was fitted with two valves from a specially bred cow’s heart during a two hour operation at University Hospital in Coventry and was awake through the entire thing

John’s heart failure left him too ill to survive a general anesthetic so he remained awake through the surgery

A retired paramedic has become the first patient to receive a double heart valve transplant while still awake.

John Smallwood, 74, was fitted with two valves from a specially bred cow’s heart during a two hour operation at University Hospital in Coventry.

Because his heart failure left him too ill to survive a general anaesthetic, he remained awake through the surgery.

And he had to stay perfectly still as the slightest move could have caused a fatal error.

John said: “It was like something out of Star Wars. I feel incredibly lucky to have had this operation.

“It is a great step forward, like the first heart transplant. Hopefully it will open the door for others like me who are deemed too risky for open heart surgery or a general anesthetic.”

John had already had open heart surgery to repair a leaky mitral valve nine years ago. It was initially a success, allowing him to return to work until he retired a year later.






John at University Hospital Coventry ahead of his surgery





John Smallwood, 74, was fitted with two valves from a specially bred cow’s heart

But his mitral and aortic valves began leaking again in 2019, allowing blood to travel through his heart in the wrong direction. This time open heart surgery was not an option.

As his condition deteriorated the father-of-two grew so exhausted he struggled to care for his disabled wife Carol, 73.

John, from Nuneaton in Warwickshire, said: “I got out of breath just talking on the phone.

“If I went for a walk, it felt like my battery ran out halfway down the road. I didn’t know how long I
had left.”

It was only when John attended a Sunday catch-up clinic last summer – arranged to cut waiting lists after the pandemic – that he discovered he was a candidate for a pioneering heart valve replacement.

Heart surgeon Nishant Gangil, who led the operation, said: “The first time I saw John, he was huffing and puffing just walking to the examination room. He had lost hope and accepted his fate.

“I told him even though traditional surgery wasn’t an option, there was a novel treatment for him and we could implant the valves through the groin.

“We have replaced aortic valves this way since 2007. But this was more difficult, because the mitral valve needed replacing as well.






Heart surgeon Nishant Gangil who led the first awake double heart valve transplant

“We had to use a special needle to create a hole in his heart and deliver the second valve through that.

“Only a handful of these cases have been done worldwide.

“And we were going to do it under local anaesthetic, while John was still awake.”

John admits: “I began getting a bit twitchy when they started talking to me through it. I like to bet on the horses, but when it’s your life on the line, you want to know you’re backing the favourite.”

After discussing his options with his family, John agreed to have the surgery at University Hospital Coventry & Warwickshire in September last year.

As he was wheeled to the operating theater, he was advised to close his eyes so he wouldn’t be overwhelmed by the number of doctors.






John’s mitral and aortic valves began leaking again in 2019, allowing blood to travel through his heart in the wrong direction

He said: “Being the fool I am, I kept them open.

“There must have been 15 or so outside and another five or six with the team inside. I thought, ‘Blimey, are they all here for me?’”

Though there were several moments when the slightest mistake would be deadly, Mr Gangil and the team talked to John throughout to reassure him and help him remain calm and still.

Mr Gangil said: “We kept telling John what was happening, otherwise he could have got anxious during such a long operation.

“He was very brave and cooperated with everything. His mental strength helped him to come through something that was quite unique.

“We are ecstatic with the results.”







John had part of.a cow’s heart valve inserted into his own
(

Image:

Getty Images/Science Photo Library RF)

John said: “Mr Gangil came to see me that evening and had me walk up and down the ward a few times.

“Then he said he was off for a glass of champagne.”

John, a Territorial Army veteran who fellow paramedics nicknamed Foggy after the Last of the Summer Wine character, spent just two days recovering before going home.

He said: “I can’t believe how much better I feel now. It’s like I’ve been reborn. I can do everything I couldn’t do before – look after my wife, change the bed, go out for walks, do the shopping. I haven’t felt this good since my late 30s.”

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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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