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Newer than new

Toronto, February 9, 2015

By Geoff Koehler

Dr. Chris Buller and Dr. Mark Peterson during a cardiac procedure
Dr. Chris Buller and Dr. Mark Peterson during a cardiac procedure. (Photo by Geoff Koehler)

When Keith Adams came to St. Michael’s Hospital, he’d already suffered one heart attack and knew his faulty heart valve was in desperate need of repair.

His referring physician told Adams to expect a new treatment, called MitraClip, which has been available in Ontario for only 18 months. However, Adams’s cardiologist, Dr. Neil Fam, saw him as a perfect candidate for an even newer procedure, Edwards’ transcatheter mitral valve replacement. Adams became the first patient in North America treated with this device and only the fifth in the world.

“Mitral regurgitation, which Adams suffered from, occurs when the mitral valve leaks, causing blood to flow backwards toward the lungs instead of forward to the rest of the body,” said Dr. Fam, director of the hospital’s Cardiac Intensive Care Unit. “As a result, patients can develop heart failure, heart rhythm problems and other complications.”

Mitral regurgitation is most often treated by repairing the valve during open-heart surgery but the St. Michael’s team considered the 77-year-old from Oshawa too sick to survive such a surgery. They also decided that Adams’ valve was the wrong size and geometry for treatment with MitraClip.

“We’d been approached by Edwards, a medical device company, which needed our expertise in catheter-based intervention,” said Dr. Mark Peterson, a cardiac surgeon. “They were working on a minimally invasive method of replacing valves and chose St. Michael’s to test their new device because of our specialty in using catheters at the tip of the heart.”

Did you know?
MitraClip therapy is a relatively new treatment. Using a catheter, surgeons and interventional cardiologists can use a MitraClip to clamp part of the leaky mitral valve and reduce mitral regurgitation.

While Adams’ heart was still beating, Dr. Peterson and interventional cardiologists Dr. Chris Buller and Dr. Fam guided the new catheter-based valve through the apex of Adams’ heart to the mitral valve. Once the new valve was deployed, it functioned perfectly and immediately reduced the pressures in his heart and lungs.

Dr. Neil Fam
Dr. Neil Fam, director of St. Michael’s Cardiac Intensive Care Unit
“An estimated 400,000 Canadians have moderate to severe mitral regurgitation and many of them, like Keith, are too sick for open-heart surgery,” said Dr. Buller. “With the addition of MitraClip and transcatheter mitral valve replacement procedures, St. Michael’s is the only Toronto hospital able to offer the full range of therapeutic options for patients with mitral valve disease.”

Adams is still doing well and is grateful that he and his wife Melva–whom Adams met on a blind date in 1958–will be able to celebrate their 55th wedding anniversary in August.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

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