Mazankowski offers minimally invasive heart surgery

Surgeons now able to replace failing heart valves without major surgery

EDMONTON – The Mazankowski Alberta Heart Institute is now home to a minimally invasive heart surgery program, enabling cardiac surgeons to avoid opening the chest when performing major, open-heart surgery on hundreds of patients each year.

Traditionally, surgeons cut open the chest and use their hands to hold or manipulate the heart during surgery. Using the minimally invasive approach, surgeons make a small incision through the ribs to access the heart and complete the procedure using state-of-the-art equipment and a tiny camera.

“This technique results in expedited recovery after surgery, a shorter hospital stay, and allows our patients to return to normal activities more quickly,” says Dr. Jeevan Nagendran, cardiac surgeon at the Mazankowski. “Cosmetically, patients are left with a minimal scar below the breast rather than a large incision line down the centre of the chest at the sternum.”

Candidates for the minimally invasive open heart surgery include patients requiring an aortic valve replacement or mitral valve repair or replacement; procedures which enable surgeons to repair or replace failing heart valves, or those diagnosed with atrial septal defect (ASD), a hole in the muscular wall that separates the heart’s two upper chambers. Twelve patients have undergone the procedure since the program was launched in May.

The minimally invasive heart surgery program would not be possible without the support of the University Hospital Foundation, whose donors generously funded the purchase of the minimally invasive equipment Dr. Nagendran uses in surgery. The foundation also provided three years of research funding as part of Dr. Nagendran’s recruitment back to Edmonton.

“The University Hospital Foundation is proud to have raised one in four dollars that built the Maz, and to continue to fund innovative technology and groundbreaking research that ensure Albertans have access to the very best medical care when they need it most,” says University Hospital Foundation Board Chair Jim Brown. “By providing the funds required for new recruits to hit the ground running – both in their clinical practice and in their research – donors are helping to attract the best and brightest doctors from around the world to the University of Alberta Hospital site.”

Dr. Nagendran – who was born, raised, educated, and medically trained in Edmonton – completed a one-year fellowship through Western University at the London Health Sciences Centre in London, Ont., where he learned the complex procedure. In 2013, he was awarded the most prestigious honour in the world for cardiac residents, the C Walton Lillehei, PhD MD Young Investigator’s Award.

After his recruitment back to Edmonton and the Mazankowski, Dr. Nagendran knew a dedicated, specially trained team would be needed to make the program a success. A team comprised of cardiac surgeons Dr. Michael C. Moon and Dr. Mohammed Al-Aklabi, anesthesiologist Dr. Anthony George, nurse Maricon Salvador and perfusionist Jackie Archibald travelled to London to observe the procedure over two days.

During the first minimally invasive procedure performed at the Mazankowski last May, Dr. Nagendran asked his mentors, Dr. Bob Kiaii and Dr. Michael Chu from the London Health Sciences Centre, to monitor the first few cases, something that provided comfort to his first patient.

Racha Kamal, 27, started experiencing chest pain approximately six years ago. After being referred to a cardiologist at the Mazankowski, Kamal was diagnosed with ASD.

When offered the choice between the less invasive procedure and traditional open-heart surgery, Kamal was nervous to be the first patient to undergo the minimally invasive procedure.

“The prospect of a smaller scar, getting out of the hospital quicker and recovering faster all sounded great, but I wished they could have had a few patient success stories before it was my turn,” says Kamal. “But for Dr. Nagendran to tell me he wanted his mentors there made me more comfortable and helped him earn my trust.”

Kamal spent one night in intensive care and three days on the cardiac ward before being discharged. Open-heart surgery patients typically stay in hospital from five to seven days.

“There were so many advantages of having the minimally invasive procedure,” says Kamal. “I was out of the hospital faster, I wasn’t on long-term medication, and my recovery was faster. I’m so glad this option was available for me in my community.”

The University Hospital Foundation raises and manages funds to advance patient care, research and healthcare education at the University of Alberta Hospital, the Mazankowski Alberta Heart Institute and the Kaye Edmonton Clinic.

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

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