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Cardiac hybrid surgery buys time for Calgary newborn

January 27, 2015

Mom grateful equipment, expertise available in Alberta

Story by Sharman Hnatiuk; photo by Mathew Martin

Isaac Tymchuk was just 16 days old when he made medical history.

Last October, Isaac became the first baby in Western Canada to undergo a cardiac hybrid procedure, performed in the new hybrid operating room at the Mazankowski Alberta Heart Institute in Edmonton.

Isaac was born with critical aortic valve stenosis, a narrowing of the valve between the left ventricle of the heart and the largest artery in the body that caused the left side of the boy’s heart to be smaller than it should be.

Calgary mother Shandra Tymchuk holds her four-month-old son Isaac, who became the youngest patient in Western Canada to undergo cardiac hybrid surgery last October when he was barely two weeks old. Rather than perform a complex, open-heart surgery on the newborn, his pediatric cardiac team at the Stollery Children’s Hospital opted for a less-invasive hybrid procedure that would give his heart time to grow.

This milestone procedure involved an interventional cardiologist (cardiac specialists who treat heart defects using minimally invasive, catheter-based techniques) and a cardiac surgeon working simultaneously in an operating theatre with the advanced imaging equipment that is necessary for catheter procedures.

“Thanks to the new hybrid OR, we were able to perform this less-invasive procedure initially that eliminates the need to put a two-week-old baby on a heart-lung machine and enables us to delay the complex surgery until he is older. This should improve Isaac’s chances of a positive outcome,” says Dr. Andrea Wan, pediatric cardiologist at the Stollery Children’s Hospital.

Cardiac surgeon Dr. Mohammed Al Aklabi inserted bands to regulate the flow of blood to the lungs; at the same time, Dr. Wan inserted a stent through a catheter into a small artery that typically closes in the first days of the life, giving Isaac’s heart another route for blood to circulate through his body.

“Having access to the hybrid OR means we can delay performing a complex open-heart surgery on a newborn,” says Dr. Al Aklabi. “The procedure buys us time to see how Isaac’s heart will grow before proceeding with a double- or single-ventricle repair when he is closer to six months of age.”

Shandra Tymchuk, Isaac’s mom, learned 21 weeks into her pregnancy that her baby had a congenital heart defect.

“Since my husband Matt and I first learned about Isaac’s congenital heart defect, we have taken every option available to give his heart the best chance possible,” says Tymchuk.

She was flown to Toronto for an experimental procedure to dilate Isaac’s aortic valve in the womb during the second trimester of her pregnancy in hopes of keeping him alive and encouraging the left side of his heart to grow. The procedure was successful; however, Isaac required additional interventions following birth.

Tymchuk says she’s thankful her son’s continued care can be provided in Alberta.

“We are so grateful to live in a province where we have access to the equipment and expertise at the Stollery Children’s Hospital and the Mazankowski Alberta Heart Institute,” she says.

Approximately one per cent of children are born with a congenital heart defect.

Through donor generosity, the University Hospital Foundation provided $6.6 million to fully fund the development of a hybrid operating room for the Mazankowski. About 50 procedures have been performed in the hybrid OR since its opening last April.

“The Mazankowski Alberta Heart Institute was built to deliver the highest level of care to patients young and old,” says Joyce Mallman Law, President of the University Hospital Foundation.

“Our donors are proud to have fully funded the cardiac hybrid operating room and are delighted that the littlest patients have benefited from the world-class care that doctors are able to provide there.”