Prince Philip went through a ‘successful procedure’ yesterday for pre-existing heart disease, Buckingham Palace confirmed today.
But exactly which treatment the Duke of Edinburgh – who had a stent inserted during heart surgery in 2011 and battled a secret heart disease for 30 years – remains a mystery.
The 99-year-old man has spent 16 nights in the hospital so far, after being admitted to a private institution with an undisclosed infection on February 16. His infection was not related to the coronavirus.
He was transferred to the major heart center St Bartholomew’s Hospital in London on 1 March for ‘testing and observation’ of a pre-existing heart disease.
Cardiologists told MailOnline today that the most recent operation may have involved placing a second stent, replacing one or placing a pacemaker.
Buckingham Palace officials said that while the duke – who will turn 100 in June – remains comfortable, they expect him to remain in the wards until “at least the end of the week”.
Camilla, Duchess of Cornwall, said yesterday during a visit to South London that Prince Philip was ‘slightly improving’, adding: ‘We keep our fingers crossed.’
The Duke of Edinburgh has spent 16 nights in the hospital due to an unidentified infection and “observation” of latent heart disease. He was transferred to the main cardiac center at St. Bartholomew’s Hospital in the city of London on Monday
A stent is a small tube used to clear a blockage in an artery. It is inserted and expanded with a balloon to expand the artery and ensure that the blood flows back normally. Dr. Aseem Malhotra, an NHS cardiologist, said it was possible that Prince Philip was installing another
Above is an explanation of how a stent is placed
Will Prince Philip receive a second stent during hospitalization to treat a heart block?
An NHS cardiologist suggested that Prince Philip may receive a second stent while in hospital, arguing that his infection may have put pressure on his heart and triggered a partial blockage in his coronary artery.
Stents are small tubes used to clean arteries and allow blood to flow normally. During an operation of up to two hours, they are inserted into a block and inflated to widen the blood vessel.
They are then left with the doctors saying that the procedure is permanent, although in some cases they need to be replaced.
There are three coronary arteries flowing to the heart, and Duke has installed a stent in one of them ten years ago at the Royal Papworth Hospital in London.
Dr. Aseem Malhotra, a cardiologist at the Academy of Medical Royal Colleges, said it was possible that Duke could receive a second stent adapted to a separate coronary artery.
“The infection may have put pressure on your heart and triggered a small heart attack or unstable angina (when the heart muscle doesn’t get enough oxygen because of blood flow problems),” he told MailOnline
“There are three coronary arteries, it is more likely that he has had a new block and needs a second stent.
“He is fortunate to be in a country where some of the best cardiologists in the world live.”
The duke imagined leaving King Edward VII hospital in central London on Christmas Eve 2019, where he spent four nights before heading home to Sandringham for Christmas. Buckingham Palace said the stay was in a ‘pre-existing condition’
Could doctors be replacing your stent or removing a blockage that could have formed inside it?
It was also suggested that the Duke could be in the hospital because doctors are either replacing the stent he had put in ten years ago, or removing a blockage that had formed inside him.
Experts say, however, that it is extremely rare that any stent needs to be replaced – and any blockages within it would only appear in the first six months.
Harvard Medical School says online in response to a question that asks if they ‘wear out’ after a few years: ‘What is important for the future is that you needed a stent in the first place. Other arteries, or points in the same artery, almost certainly have cholesterol-filled plaques that can cause blockages, or worse.
They said it is possible to form a blockage inside the stent, but it usually occurs within the first six months. If they stay in place for longer without problems, it is a ‘sign that you have done your job well’.
After Prince Philip made his adaptation in 2011, he was not readmitted to the hospital with heart problems until this year, according to Buckingham Palace. This suggests that the operation was successful.
When the stent is implanted, the tissue grows over it, making it part of the artery wall. But, if the damaged tissue grows, it can trigger additional blockage and mean the need for more operations.
Queen Elizabeth and Prince Philip photographed in the quadrangle of Windsor Castle before their 99th birthday in June last year
Did the prince install a pacemaker to treat his underlying heart disease?
It was also claimed that the duke is installing a pacemaker to treat his heart condition.
The heartbeat is usually controlled by electrical signals from the body’s internal “pacemaker”, which fires between 60 to 100 beats per minute. But the pulse can be interrupted – in a condition known as arrhythmia – by other heart disease, smoking or stress.
A pacemaker prevents this from happening by emitting regular electrical signals. They can be placed just below the chest in an hour-long operation, which would require a day of rest at the hospital to ensure the procedure works.
Dr. Malhotra told MailOnline: ‘A less likely option instead of a stent would be that he would need a pacemaker if he had a problem with his heart rate.’
There was no previous suggestion that the duke suffered from an irregular heartbeat, although he has an underlying heart problem that could trigger it.
Palace officials remained silent as to the cause of their hospital stay.