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St. Paul's team is world's first to perform new heart valve replacement surgery
<< BACK | Download Word File Vancouver, December 16, 2005 — A team of specialists at St. Paul's Hospital recently performed the world's first minimally invasive "beating heart" aortic valve replacement surgery. Cardiac surgeons Drs. Sam Lichtenstein, Anson Cheung and Jian Ye recently worked with interventional cardiologists Drs. John Webb and Ron Carere and echocardiologist Dr. Chris Thompson to replace the aortic valve of a patient who would not have been able to endure open-heart surgery. "We are very excited to be the first team in the world to perform this new procedure," Lichtenstein said. "Most importantly, we were able to improve the health of a patient who had no other options." Heart valve replacement surgery usually requires a long incision in the centre of the chest to enable surgeons to expose the heart, which is temporarily stopped while the valve is replaced and sutured in place. A heart-lung bypass machine is used to keep the patient's blood circulating until the heart function is restored. Instead of this major operation, the team was able to use a special valve that folds to the diameter of a pencil and can be inserted via a small four-inch incision between two ribs. Guided by moving x-ray and echocardiography (heart ultrasound) pictures, the team was able to insert the valve through the base of the patient's heart. When in place, the valve was unfolded, pushing the existing valve tissue aside. The new procedure is known as trans-apical placement and is one of the therapies available in the evolving field of "closed heart" procedures. Earlier this year, Webb became the first interventional cardiologist in North America to perform a successful percutaneous aortic valve replacement. In this procedure, the same type of folding valve is threaded up to the patient's heart through the circulatory system using a catheter inserted in the patient's groin. (The valve for both procedures was developed by Edwards Lifesciences Corporation.) The development of percutaneous valve replacement opens a new door for some patients who could not safely undergo open-heart surgery. However, about 30 per cent of patients over 70 years have blood vessel disease in the major arteries of the lower body that would also preclude them from having the percutaneous procedure. The new surgical technique pioneered by Lichtenstein and the St. Paul's Heart Centre team could one day be an option for these patients. Will minimally invasive heart valve replacement surgery ultimately be the answer for all patients? Not yet, says Lichtenstein. The team current plans to provide the procedure on compassionate grounds for patients who are too frail to survive open-heart valve replacement surgery. The next step could be offering it to patients for whom open-heart surgery is possible but considered to be high-risk. However, more work needs to be done before this becomes something that would be an alternative for younger, healthier patients. This world-first at St. Paul's was made possible by the collaborative relationship between surgeons and interventional cardiologists at the hospital's Heart Centre, Lichtenstein said. "We all bring different skills to the table and our willingness to collaborate enabled us to perform this new procedure successfully." -30- Contact: Providence Health Care Communications Tel. 604-806-8022 Pager 604-667-4397 << BACK | Download Word File |
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