June 8, 2016
The heart team at London Health Sciences Centre (LHSC) is the first in Canada to perform a new surgical technique available to very select and complex patients whose arterial vessels are inaccessible due to calcified and narrowed arteries. The goal of the procedure is to restore normal blood flow through the heart and the rest of the body and reduce paravalvular leakage around the valve.
The transcaval approach was performed by Drs. Rodrigo Bagur, Michael Chu, Pantelis Diamantouros, Patrick Teefy, Dan Bainbridge, Luc Dubois and Bob Kiaii in March 2016.
The transcaval TAVI approach allows access to the diseased aortic valve through the femoral vein by creating a temporary passage from the veins to the aorta. The collapsed replacement valve is moved through the vein and inferior vena cava and then crossed over into the abdominal aorta where it is guided to the aortic valve. Contrast-enhanced CT scans are taken before the procedure to assess patient’s suitability for this procedure and help guide the surgeon’s path through the patient’s anatomy.
The technique is available to very select and complex patients whose arterial vessels are inaccessible due to calcified and narrowed arteries, and reduced lung capacity. “For some patients, the severity of their heart disease means there are limited treatment options available to them. This new catheter-based approach gives them an option they otherwise would not have,” says Dr. Rodrigo Bagur, interventional cardiologist, LHSC.
William (Wallace) Snider, 78, from Sarnia Ontario, the first Canadian patient to undergo this new catheter-based technique had been suffering from shortness of breath and fatigue for a few years. A former truck driver, his heart condition impeded his quality of life and limited his ability to play with his grandchildren or woodwork.
“We could not have performed the traditional approaches through Wallace’s chest or peripheral vessels because his arteries were too calcified and narrowed and there was a concern that his lung capacity would have dangerously diminished due to his pre-existing lung condition,” adds Dr. Michael Chu, cardiac surgeon, LHSC.
Walking the day after his surgery, Snider spent Easter Weekend at the hospital with visits from his wife, daughter and granddaughter and was discharged shortly after the long weekend and just before his Birthday. “I’m looking forward to a bit of travelling with my wife, Barbara. I feel lucky and I’m grateful for the excellent care I’ve received.”
Front row: Wallace Snider surrounded by his wife Barbara (left) and granddaughter Lyndsay, is joined by LHSC’s heart team, from left, Drs. Bob Kiaii, Pantelis Diamantouros, Rodrigo Bagur, Michael Chu, Patrick Teefy, Aashish Goela, Ian Chan, Daniel Bainbridge, and Vincenzo Giambruno, who performed Canada’s first transcaval TAVI.