New Brunswick

N.B. Heart Centre offers new, less invasive alternative to open heart surgery

The New Brunswick Heart Centre became the first in Atlantic Canada to successfully perform a MitraClip procedure - a less invasive alternative to open heart surgery that offers new hope to some patients.

Saint John-based centre becomes first in Atlantic Canada to perform MitraClip procedure

John Peacock pictured here with the team who performed the mitraclip procedure on him on March 14 - Danielle Knox, MRT; Dr. Vernon Paddock, interventional cardiologist; Ellen Maclennan, RN; Dr. Jennifer Cloutier, cardiac anaesthesiologist; Dr. Robert Teskey, interventional cardiologist; Allen Floyd, RN; Angela Millet, RN, and Dr. Sohrab Lutchmedial. Missing from photo: Heather O’donnell, Dr. Jean Francois Legare, cardiovascular surgeon. (Horizon Health Network)

John Peacock says he will be will be celebrating his 71st birthday on Sunday, thanks to a team of specialists at the New Brunswick Heart Centre in Saint John.

Peacock, who suffered from a so-called leaky heart valve, underwent a MitraClip procedure earlier this month — a first for Atlantic Canada.

It's an "incredibly sophisticated" minimally-invasive repair procedure that gives new hope to patients who are too sick to withstand the risks or rigours of open heart surgery, said Dr. Sohrab Lutchmedial, director of the cardiac catherterization lab.

At Christmas I thought I would not see my birthday if nothing was done.- John Peacock, patient

The mitral valve is a one-way valve located between the heart's two left chambers that lets blood flow from the atrium to the ventricle.

When patients have a leaky mitral heart valve, known as mitral regurgitation, instead of the blood flowing out to their muscles and brain, it flows backwards into their lungs, leaving them short of breath and with no energy.

Peacock, of Quispamsis, says he reached the point where he couldn't even tie his shoes or roll over in bed without getting winded.

"At Christmas I thought I would not see my birthday if nothing was done."

The MitraClip procedure works much like an old-fashioned clothes pin, said Dr. Sohrab Lutchmedial. (Horizon Health Network)

But the married father of three and grandfather of two already had already undergone a triple bypass 14 years ago, so cutting his chest open again was not an option because doctors feared his breastbone would not heal.

Peacock, who has diabetes, wasn't a candidate for an artificial valve being inserted between his ribs either. He was considered too high-risk, he says.

His doctors recommended the MitraClip procedure, also called a transcatheter mitral valve repair.

"The best way to describe it would be like an old-fashioned clothes pin that you're trying to grab these sheets flapping in the wind," said Lutchmedial.

"But you're trying to do it while the patient is of course alive, his heart is beating and you're grabbing it in real time."

Quicker recovery

Instead of having to open up a patient's chest, doctors access the heart through a large vein in the leg and use ultrasound to guide the catheter up to the heart. (Horizon Health Network)

Doctors access the patient's heart through a large vein in the leg and use ultrasound to guide the catheter up to the heart.

Peacock's procedure took about five hours with his team consisting of members from anesthesia, cardiac surgery and interventional cardiology.

"It does take a lot of time and a lot of practise and a lot of patience, but happily enough last week we were successful with our first two procedures," said Lutchmedial.

Peacock and the other patient — whom Lutchmedial described as being "almost room-bound," not just house-bound because they were so sick — were both discharged within two days.

By comparison, patients who undergo open heart surgery typically spend at least four or five days in the hospital, sometimes up to a week, he said.

"So it's a tremendous difference in recovery time."

For select patients

Dr. Sohrab Lutchmedial (centre) hopes the New Brunswick Heart Centre will become the go-to centre for patients across Atlantic Canada who would benefit from the MitraClip procedure. (Facebook)

Now, the centre hopes to provide the procedure to patients from Nova Scotia, Prince Edward Island and Newfoundland and Labrador, said Lutchmedial.

"We're trying to become a go-to centre in Atlantic Canada for any type of procedures that you need for your heart."

The NBHC, in operation at the Saint John Regional Hospital since 1991, is the provincial referral centre for adult tertiary cardiac care in New Brunswick and surrounding areas.

Its services include general cardiology, interventional cardiology, electrophysiology and cardiovascular surgery.

The centre's most common procedure is fixing arteries during heart attacks, said Lutchmedial, but it has also become a national leader in providing aortic valve procedures during the past four or five years and is now the first centre east of Montreal to have a MitraClip program up and running, he said.

Lutchmedial expects only 10 to 12 New Brunswickers a year will qualify for the procedure, and comparable numbers of patients from the other Atlantic provinces.

"Certainly the traditional therapies, that is medication, lifestyle [changes] and traditional surgery are going to be the mainstays of treatment for the vast majority of patients in our province."

But as the population ages and patients have more complex health care needs, he believes such non-invasive procedures will prove to be "the future of medicine."

Peacock says he's looking forward to his future now that his stamina is steadily improving.

"Just the typical pleasures" — spending quality time with his wife of 49 years, Lillian, going out with friends without needing them to pick him up and drop him off at the door, and being healthy enough to travel to Ontario to visit his children and grandchildren.

He says he had little quality of life for months before the procedure and has "nothing but admiration" for Lutchmedial and the rest of the team who gave him his life back.

With files from Information Morning Saint John