Pioneering procedure speeds recovery after open-heart surgery
November 12, 2009
After Richard Cuming had open heart surgery in 2007, his surgeons used the traditional method to reattach his breastbone – they sewed it together with stainless steel wire and waited for new bone growth to fuse the severed bone back together.
But the wire broke and Cuming was in constant pain.
"I couldn't accomplish simple tasks like squeezing toothpaste, turning the steering wheel in my car or pulling open a heavy door without discomfort and pain," the 62-year-old Calgary man says.
"Anytime I coughed or sneezed, there was movement in my chest and significant pain. I think the worst part of the ordeal was that I stopped doing things in case they would hurt."
In June, Cuming had his breastbone put back together again but, this time, instead of using wire, doctors "glued" it together with a state-of-the-art biologic adhesive made from a castor bean plant.
It's called KryptoniteTM, a bone cement that was developed by a U.S. medical research company more than a decade ago for use with cardiac, trauma, orthopedic and spine procedures.
In a process pioneered by Dr. Paul Fedak, a cardiac surgeon and Alberta Heritage Foundation for Medical Research Clinical Investigator, surgeons take a few minutes at the end of open-heart surgery to apply the sticky substance to the ends of the broken bones. It bonds them together, speeding up the healing process and reducing post-op complications.
The patient needs far less – if any – narcotics or other strong medication for the pain.
"I had a little bit of pain, but this was a walk in the park compared to my earlier recovery," Cumming recalls.
"I can do anything I could do prior to the original surgery. I feel wonderful."
Cuming is one of more than 20 Calgary open-heart surgery patients who Dr. Fedak has glued back together with Kryptonite since April 2009.
Each patient reports less pain and discomfort after surgery and therefore has a faster recovery.
Fedak says none of the patients has had any complications to date.
"Everyone knows that broken bones need a cast to heal properly. But we can’t put a cast around your whole chest after surgery or you couldn’t breathe, so we needed another solution," he says.
"We can now heal the breastbone in hours instead of weeks after open-heart surgery. Patients can make a full recovery after surgery and get back to full physical activities in days instead of months."
Dr. Fedak's co-investigator in the Kryptonite trial, Dr. Kathryn King, RN PhD, is a cardiovascular nurse scientist at the Faculties of Nursing and Medicine.
"We know that recovery from sternotomy is a multi-faceted process that includes not only healing of the breastbone but the ability to return to normal activities," she says.
"Being able to resume normal activities is a hallmark of a good recovery; this surgical innovation should enable that."
Before long, using Kryptonite could become standard practice in the more a million open-heart surgeries around the world every year. Dr. Fedak has presented his work to colleagues in Edmonton and he's trained surgeons in Montreal, Germany and Italy, who are now performing the procedure.
Furthermore, more than 500 open-heart patients around the world will be treated with Kryptonite over the next year or two as an international "STICK" (STernal Innovative Closure with Kryptonite) trial gets underway.
Dr. L. Brent Mitchell, head of the Clinical Department of Cardiac Sciences at Alberta Health Services, says this is good news for individuals requiring cardiac surgery.
"I used to warn my patients going for open-heart surgery that they would feel like they had been hit by a truck during a protracted recovery period," he says.
"Now, it will be more like they have been hit by a tricycle for a few days."