October 1, 2004

Debbie Neufert
Media Relations, LHSC
London Health Sciences Centre
519-685-8500, ext. 74772

Jayne Graham, Special Projects Manager
Lawson Health Research Institute
(519)685-8500, ext. 77696

Combined innovative method to treat heart disease a North American first

(LONDON, Ontario) - An inter-disciplinary medical team at CSTAR (Canadian Surgical Technologies & Advanced Robotics) is leading the way in the latest innovation to treat heart disease. The CSTAR team is the first in North America to complete two different procedures to clear blocked arteries, minimally invasive robotic-assisted heart bypass surgery and angioplasty with stenting, at the same time in the operating room.

Although the procedures are not new, the fact that they are combined into one episode of care is. Until now, patients needing both procedures would have bypass surgery first and then angioplasty a day or two later or vice versa. Advanced technology, such as 3-D imaging in CSTAR's specialized Hybrid Operating Room/Angiosuite at London Health Sciences Centre, one of a few such facilities in the world, has made this new intervention possible.

"This latest innovation to benefit patient care has been realized because of the generosity of London philanthropists Richard and Beryl Ivey, as well as the investment by LHSC and its Foundation into the advancement of CSTAR", says Tony Dagnone, LHSC President and CEO.

"Combining heart bypass surgery and angioplasty in one operating room opens up an entirely new option to treat select patients with heart disease," says Bob Kiaii, leader of CSTAR's Robotic Coronary Artery Bypass research project and cardiac surgeon at LHSC. "The benefits of this new hybrid procedure include a reduced hospital stay by approximately two days compared to the traditional approach to treatment, and a faster recovery, which benefits patients as well as the health care system."

One of the first patients to have the "hybrid" procedure is Karl Ferrier. The 52-year old contractor from Priceville, Ontario, a community south of Owen Sound says, "It was exciting to be part of this new procedure. It went really well, I was glad to be able to have everything done at once and I was out of hospital in three days, which was great."

Approximately 50 "hybrid" procedures are expected to be completed this year at London Health Sciences Centre, and several have already taken place over the last month. Dr. Kiaii, uses the four-armed da Vinci robot to bypass a single blocked coronary artery. The surgery is also performed without stopping the heart as opposed to traditional bypass surgery where the heart is stopped and the heart/ lung machine is used to circulate the blood supply. According to Dr. Kiaii, "When we use what we call an 'off pump' procedure, patients may experience a reduced risk of developing complications such increased inflammation, neurological side effects and bleeding."

Immediately following the surgery, Bill Kostuk, cardiologist at LHSC, completed a percutaneous coronary intervention (PCI) or angioplasty with stenting to open additional narrowed arteries. According to Dr. Kostuk, "The one procedure allows us to do a PCI on patients at a reduced risk". PCI involves the advancing of a small tube (catheter) from the groin to the mouth of the artery. Through this tube a smaller catheter with a balloon on the tip is passed across the narrowed segment. The balloon is inflated, which then presses the fat deposits against the artery wall and increases the opening. A stent (wire mesh) is then placed across the narrowed opening. The stent is pressed into the wall of the vessel by inflating a balloon. The end result is a wide-open blood vessel and normal blood flow.

Patients who would be considered for the hybrid research protocol are those with blocked heart arteries who would benefit from a minimally invasive bypass with robotic assistance and who also have blocked arteries not accessible through a minimally invasive approach that would be treated with interventional cardiology (PCI).

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Research at CSTAR is supported by grants from the Canada Foundation for Innovation and the Ontario Government. CSTAR is a collaborative research program of London Health Sciences Centre and the Lawson Health Research Institute and is affiliated with The University of Western Ontario.

CSTAR occupies the top two levels of the new Legacy Research Pavilion at the University Campus of London Health Sciences Centre in London, Ontario.