Starting in September, St. Mary’s will add a minimally invasive cardiac procedure to repair aortic valves in patients who are too sick or high risk to undergo valve replacement with traditional open heart surgery.
Known as Transcatheter Aortic Valve Implantation (TAVI), the procedure will be performed in the Cath Lab by interventional cardiologists and cardiac surgeons. St. Mary’s is the only cardiac surgical centre in Ontario currently not offering the procedure. Each year about 50 patients from Waterloo Wellington must travel to centres in London, Hamilton or Toronto for TAVI,waiting an average of 90 days.
Earlier this year the Waterloo Wellington Local Health Integration Network approved funding for St. Mary’s to begin offering TAVI.
“We are currently sending patients to centres with long waiting lists, so we are very excited to begin offering timely access to TAVI close to home,” says Andrea Lemberg, St. Mary’s Cardiac Program Director. “We have been approved to do 50 procedures in our first year and at this point do not have a wait list.”
The aortic valve usually opens when blood is pumped from the heart to the rest of the body. In some people, the valve does not open and close properly. In some cases, open heart surgery too risky. Without surgery their chance of survival is poor.
With TAVI, a self-expanding aortic valve is implanted and patients are given conscious sedation. They will recover in the Coronary Care Unit, with
anticipated discharge within 48-72 hours.
“TAVI is now the established technique for high-risk patients with severe aortic stenosis,” says Dr. Jaffer Syed, an interventional cardiologist at St. Mary’s and physician lead for TAVI implementation. “It can greatly improve quality of life and improve survival.”
St. Mary’s will begin scheduling TAVI procedures one or two days a month, with two or three procedures in a day. Patients will undergo multiple tests before the procedure. Of those eligible for TAVI, some will need a pacemaker prior to or following the procedure.
The demand for TAVI is rising and other centres are expanding access, says Dr. Syed. Increasingly the procedure is being offered to lower risk populations. “We will ramp up as we can,” he says.
Pictured above "Cardiac Program Director Andrea Lemberg (front left) is shown with members of the TAVI Heart Team, including Rebecca Gies, Regional Cardiac Care Coordinator for the TAVI program, Dr. Jaffer Syed, (rear left) TAVI physician lead, and Dr. Sammy Ali. Absent from the photo are team members, Dr. Gary Salasidis, and Dr. Hahn Hoe Kim."