Cutting-edge heart surgery comes to province
Patients too fragile for open-heart surgery can now get their aortic valves replaced in Saskatchewan.
Dr. Jeff Booker, an interventional cardiologist in Regina who trained at the Mayo Clinic in Rochester, Minn., is performing a cutting-edge procedure called the Transcatheter Aortic Valve Implantation (TAVI).
The life-changing procedure is done on high-risk patients with narrowed aortic valves that cause strain on the heart.
“Instead of going for open-heart surgery and replacing the valve, we’re able to go in and implant a new valve inside of their existing valve with the patients awake, but comfortably sedated,” Booker said.
Interventional cardiologists insert a long narrow tube called a catheter through a large blood vessel in the groin to implant a new aortic valve. After the implant, the catheter is removed and the new valve starts working immediately.
When a properly functioning aortic valve opens, it allows blood to be pumped efficiently from the heart to the aortic artery, which delivers oxygenated blood to the entire body. The procedure takes about half the time of open-heart surgery.
“Many of these patients are older and have other health problems that would make them at high risk for open-heart surgery or not eligible at all to go through the procedure,” Booker said.
The procedure isn’t as invasive as open-heart surgery so there is less risk of patients having rhythm problems, dying or having a stroke.
The valve implants are done in Regina, but a Saskatoon team also evaluates patients and develops and administrates the program.
“We have collaborative group team conferences to review all of the patients who are going for the procedure to make (sure) that everyone is evaluated, worked up and found to be eligible in the same way,” Booker said.
Before being recommended for the procedure, patients are referred to a cardiologist and a TAVI co-ordinator in either Regina or Saskatoon and undergo several tests to determine eligibility.
A Saskatoon physician comes to Regina on procedure days to participate in the valve transplants.
Following the procedure, which is done in the catheterization laboratory at Regina General Hospital, patients typically stay in hospital for up to three days. They receive followup care in Regina or Saskatoon.
The TAVI procedure is dramatically different from open-heart surgery where patients are given general anesthetic, put on the heart-and-lung machine and go to the intensive care unit for recovery. Open-heart surgery patients are hospitalized for five days to about a week.
The new treatment improves patients’ symptoms and their lifespan, he said.
“Prior to now, either patients would go through open-heart surgery at high risk or would choose not to have anything done or the transcatheter valve procedure was offered in Canada, but not in Saskatchewan,” Booker said. “They would have to travel outside of the province to B.C. or Alberta to have it done.”
Life expectancy without a valve replacement is about two years.
Since the first procedures were performed on Feb. 28, 11 patients have received treatment in Saskatchewan.
On Tuesday, Regina Pasqua MLA Muhammad Fiaz announced the government is providing $700,000 in funding annually so patients who can’t undergo open-heart surgery can have the TAVI procedure performed in Saskatchewan.
“This will allow 25 patients each year to receive this procedure and followup support,” Fiaz said.
They would have to travel outside of the province to B.C. or Alberta to have it done.