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Hospital joins elite heart units performing valve replacement

St. Michael’s heart and vascular program has joined a select group of facilities in Canada that perform Percutaneous Aortic Valve Replacements (PAVR).

Toronto, June 8, 2009

Heart valve replacement Cardiovascular surgery and cardiology team perform the PAVR

St. Michael’s heart and vascular program has joined a select group of facilities in Canada that perform Percutaneous Aortic Valve Replacements (PAVR).

“This is a great advance for Cardiovascular surgery and Cardiology at the Hospital,” said Cardiac surgeon Dr. Mark Peterson, who in conjuction with Dr. Robert Chisholm from Cardiology, lead a specialized multidisciplinary team implanting catheter-based tissue aortic valves. “This offers us another innovative option for patients who may not be suited for a conventional, surgical aortic valve replacement.”

Patients requiring replacement of the aortic valve would normally be considered for an open heart procedure with the use of a heart-lung machine. This method can be risky in fragile, older patients with multiple co-morbidities.

“Patients with severe aortic valve stenosis and who are at excessive risk with conventional surgery, the PAVR is an option,” said Dr. Peterson. “During the procedure, we access the aortic valve either directly via a small incision at the apex of the heart, or alternatively via a small incision in the groin whereby we access the valve retrogradely from the femoral artery.”

The new valve is crimped over a balloon catheter, and under fluoroscopy and echocardiographic guidance, is moved across a stiff wire to the position of the native valve. The new valve is then deployed by inflating the balloon catheter for several seconds; this effectively displaces the old, diseased valve and leaves in place a new tissue valve.

“This is a real team effort involving surgeons, cardiologists, anesthetists, nurses from perioperative services and the cardiac catheterization lab, perfusionists, technicians and case managers,” said Dr. Chisholm. “Together we hope to improve the quality of patients’ lives, and prevent re-admissions to hospital for heart failure.”

The Heart Health Unit is also instrumental in the assessment of PAVR patients pre-operatively. The cardiovascular intensive care unit, the cardiac surgery unit and the CCU play key roles following the procedure.

With files from case manager Elizabeth Pawlowski

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