April 25, 2014
EDMONTON — Heart patients who require an aortic valve replacement (AVR) are going home sooner and healing faster thanks to a new, minimally invasive style of the surgery now available at the Mazankowski Alberta Heart Institute.
With the arrival of cardiac surgeon Dr. Darren Freed, the Mazankowski can now offer the ‘Mini AVR’ — an advanced procedure that requires only a small portion of the breastbone, or sternum, to be opened to give access to the upper heart. The procedure is available in Edmonton through support from the University Hospital Foundation.
“This surgical technique will result in a shorter length of stay in hospital, a much smaller surgical incision, decreased pain following surgery and faster healing, all of which are wonderful for patients,” says Mishaela Houle, Executive Director of Cardiac Sciences in the Edmonton Zone of Alberta Health Services.
Adds Dr. Freed: “The patient gets up and around more quickly. There’s less blood loss because there’s less surgical trauma. In general, our patients return to a better quality of life sooner.”
Joyce Mallman Law, President of the University Hospital Foundation, says the foundation is proud to have played a pivotal role in bringing Dr. Freed, with his innovative techniques and research goals, to the Mazankowski Alberta Heart Institute.
“Our community’s deep financial commitment to the Maz through their generous gifts makes the recruitment of such outstanding surgeons possible; and ensures that patients have access to the very best care, and the latest surgical techniques, when they need it most,” she says
The foundation has committed $450,000 over three years to fund Dr. Freed’s research and teaching, as well as $50,000 to pay for the specialized instruments used in the new procedure.
“I certainly do not believe that we could have recruited Dr. Freed, or anyone else with his similar combination of clinical and research excellence, without the major support of the foundation, both for the very significant research funds as well as for the new instruments,” says Dr. David Ross, Head, Cardiac Surgery, Edmonton Zone.
The aortic valve lies between the aorta, the body’s major blood distribution vessel, and the left ventricle, the big pumping chamber in the heart. Should the aortic valve become blocked, or fail to open and close properly, it can be replaced with a mechanical valve, or a tissue valve from a cow or pig.
Symptoms of a failing aortic valve include chest pain, feeling tired after exertion, shortness of breath, heart palpitations (abnormal heartbeat) and a murmur (a “swooshing” sound as it beats).
With traditional AVR surgery, the entire sternum is split open vertically with a 15- to 20-centimetre incision. With the new minimally-invasive approach, the incision opens only the top six to eight centimetres of the sternum, an option that leaves a less noticeable scar.
Typical week-long hospital stays have been reduced to three or four days, increasing access for other cardiac patients. A smaller incision also means fewer wound complications and less chance of infection, which results in fewer return visits to the hospital after surgery.
“We tell most people not to do any heavy lifting, or pushing or pulling with their arms, to protect their breastbone for the first eight to 12 weeks,” says Dr. Freed. “Yet, I’ve had patients come back to my clinic in six weeks time saying they’ve already been chopping wood with an axe. Most people will experience very rapid recovery after having it done this way.”
Margaret Kercher worked in a tree nursery prior to getting a new aortic valve last November.
“My work is very strenuous. I was just getting played out; I couldn’t do anything. I was getting weaker and tired,” says the 63-year-old resident of Fairview, located 550 kilometres northwest of Edmonton. “After surgery, I felt really good quickly. I was up walking around within a day. Within a week or two, I was helping my husband set the table.”
To date, 10 patients have undergone the Mini AVR at the Mazankowski, with this number expected to grow as Dr. Freed, also an Associate Professor with the Faculty of Medicine and Dentistry at the University of Alberta, shares his expertise and training with surgical colleagues.
“The expansion of the minimally invasive surgical program in Edmonton is a key priority for our cardiac surgery program,” says Houle, “and Dr. Freed has been a great addition to our surgical team at the Maz.”
The new technique was first developed in the U.S. over the past decade by the Cleveland Clinic, an internationally recognized pioneer in minimally invasive cardiac surgery.
The University Hospital Foundation raises funds to support innovation and excellence at Edmonton’s University of Alberta Hospital, Kaye Edmonton Clinic and Mazankowski Alberta Heart Institute. University Hospital Foundation donors help keep the Mazankowski Alberta Heart Institute on the leading edge of cardiac care by supporting new technology, techniques and procedures, and transformational research.
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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