Historic heart procedure performed at Vancouver General Hospital

A Vancouver medical team has performed an emergency heart valve replacement procedure on a critically ill patient in 19 minutes — a first in North America.

Max Morton's risk of dying from open heart surgery was '30% ... if not higher'

Max Morton (left) was the lucky recipient of a historic 19-minute emergency heart procedure that meant doctors could insert a valve into his heart without the risk of open heart surgery. (Vancouver Coastal Health)

A Vancouver medical team has performed an emergency heart valve replacement procedure on a critically ill patient in 19 minutes — a first in North America.

Soon after a 79-year old patient with a failing heart valve came into Vancouver General Hospital's ER last Friday afternoon, his blood pressure started dropping drastically in front of the doctor's' eyes.

Most patients with aortic valve problems experience the failure over the course of several days.

Max Morton's heart failed in a matter of six hours.

"At that point we had very little options," said Dr. David Wood, an interventional and structural cardiologist at Vancouver General and St. Paul's Hospitals.

"He was still awake, he was still talking with us even with a blood pressure of 60. But we knew imminently that he was going to crash."

Traditionally, doctors would perform emergency open-heart surgery on Morton in order to replace the failing valve. But Wood says Morton's risk of dying as a result was "30 per cent … if not higher."

So the team decided to attempt a procedure that had previously only ever been done on stable patients with plenty of advanced notice.

Max Morton's artifical valve, inserted in 2009, had failed and only half of the blood was being pushed out of the heart every time it beat. (Vancouver Coastal Health)

10 years in the making

The procedure, called transcatheter aortic valve replacement, involves inserting a new valve, in a tube, through the patient's femoral artery in the leg up into their heart.

This was done for the first time in the world, at Vancouver's St. Paul's hospital, a little over 10 years ago, by Dr. John Webb.

Webb was present again on Friday to help Wood complete the procedure for the first time on a critically ill patient — someone who doctors say was moments from dying.

"From the time we started to the time we finished it was 19 minutes," said Wood.

"Within about 20 minutes [Morton] was joking around about whether he was going to go on a fishing trip on Saturday."

The procedure allows the patient to be awake the whole time.

What it means for future patients

Thanks to infrastructure set up in the past decade for emergency heart procedures at Vancouver's hospitals, VGH was able to mobilize the team quickly to replace a patient's failing heart valve. (Left to right) John Webb, Maxwell Morton, David Wood, Sandra Lauck, Eleanor Triana, Andrew Busch, Adrian David (kneeling in front), Catherine Doll (Vancouver Coastal Health)

The cardiology team at VGH and St. Paul's hospital will meet to find out whether Morton's case can be replicated for other critically ill patients.

"It was probably the most exciting case, definitely that I've been involved in and the team. It was just incredible to see the power of this technology."

Wood acknowledges doctors at St. Paul's and VGH have performed the procedure a thousand times since it was first done 10 years ago, but Friday's case, where Morton was admitted and 'cured' in a matter of 2.5 hours was record-setting.

"To be able to have people come in critically ill like this, mobilize a team, and fix a valve like this through the leg, in that short period of time,  I mean — the sky's the limit now, truly."

With files from CBC Radio's The Early Edition

To listen to the full interview, click the link labelled: Vancouver doctors perform historic heart procedure.


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