WORLD FIRST KEYHOLE SURGERY

Sometimes we’re asked to do extraordinary or unprecedented things, and the case of Chris, a young 30-year-old man who was born with a complex congenital heart disease, is a good example.

Chris only had one pumping chamber (ventricle) to his heart, as opposed to the normal two. The main valve taking the blood out of the heart was severely narrowed, but as he’d already had two open heart operations in his young life and was in a terrible nutritional state, he couldn’t survive another open heart surgery. 

As a result, we were asked to do a world first, replacing that valve without opening his chest. However all the blood vessels in his body were too small to actually put in a keyhole heart valve. We had to figure out how to do that without rupturing one of his arteries.

However, not only was open surgery not really an option but also, this 30-year-old person had potentially a lot of life years in front of him and a lot of things that he would like to do. We needed to come up with a solution that would allow him to survive and enjoy that life.

We worked in an integrated team with cardiac surgeons, vascular surgeons, and interventional cardiologists to come up with a unique solution that was ultimately extremely successful. We also worked as a group for four months to build up his overall health. 

Because all his arteries were too small to accommodate the device, we figured out a technique where our vascular surgeons put a very small tube into an artery in his leg and then expanded the artery from within so that it could really accommodate a device that he otherwise could not have. 

And while we were also told that you couldn’t put the keyhole heart valve where his valve was, because it was not designed for it, by working as a heart team we were able to put a whole keyhole heart valve into his single pumping chamber, accounting for all the abnormalities that he had.

Essentially this has restored his heart valve function to normal.