Page 9 - Peter Munk Toronto Star

ON ON1 SATURDAY, JANUARY 31, 2015 TORONTO STAR⎮M9

STEVE RUSSELL PHOTOS/TORONTO STAR

Nurses clean equipment for the minimally invasive surgery to replace a heart valve.

elp place the valve, or “TAVI,” in its spot in the heart is tested before being inserted. An ultrasound probe and X-ray machine over the operating table assist the team.

am

wn the patient’s “We take the
machine that has skills of multiple
erating table. The people and use
technicians to in- them on patients
bloodstream dur- with complex
urgery to enhance problems. In the
past, patients
ne of the cardiolo- like this would
n into the valve. In get morphine
stopped and the and an apology.”
ing the narrowed
a permanent wire DR. ERIC HORLICK
e from the sack of CARDIOLOGIST

ins beating again.
s a success.
was just for those
says of the TAVI

team effort.”
e procedure, Cusi-
patient, his gloved
e directly to the
nd other doctors
isperse.
ou put pressure on
ays. “Whether it’s
it’s the same pro-

ly at this window

nce 1977 and I still
my hand on some-
t’s something you

A team of doctors performs a minimally invasive surgery to replace a heart valve with X-rays, CT scans and ultrasound.

Q&A > DR. ERIC HORLICK

Rapid assessment saves lives for those with aortic valve disease

CAMILLA CORNELL The heart cannot compensate to meet for tests. Although severe AVD is complete- “You may well
everyday needs and the patient suffers a ly treatable in most cases, these patients die or end up
SPECIAL TO THE STAR shortness of breath, chest pain, fainting and have a mortality clock ticking. Once you in hospital with
sudden death. develop symptoms and you are not a candi- heart failure
Aortic valve disease (AVD) is a life-threatening date for surgery, your mortality is 60 per while waiting to
condition that usually kills within two years. We Who does AVD affect? cent in the first year. You may well die or end see a doctor.”
asked Eric Horlick, a cardiologist and director of Aortic stenosis happens in two groups of up in hospital with heart failure while waiting
structural heart disease intervention at the to see a doctor. ERIC HORLICK
Peter Munk Cardiac Centre about a new pro- patients. The first is patients born with a DIRECTOR OF
gram that ensures patients get prompt care. congenitally abnormal valve. Those valves How will the PMCC’s new rapid-assess- STRUCTURAL
can fail in childhood, early adulthood, middle ment program speed things up? HEART DISEASE
What is aortic valve disease? adulthood or by age 60. The other group of INTERVENTION
A normal aortic valve is between four to patients are the elderly — usually 65 and up. Our aortic valve team guarantees any AT PMCC
There is wear and tear on the valve and it patient referred by a doctor will be seen by
art through a small cut near his ribs. five centimetres square and all of the blood continues to degenerate until the valve can an aortic stenosis expert within 24 hours
that feeds the body passes through it. The no longer open and close. More than one in and will get expert and timely treatment.
average patient with aortic valve disease has eight patients aged 75 and older have mod-
a narrowed aortic valve, which puts them at erate to severe aortic valve stenosis. What does treatment involve?
tremendous risk. The normal treatment for severe aortic
Why is it important for these people to be
Why? assessed quickly? valve disease is surgery — we take out the
The heart muscle has to work that much old aortic valve and sew in a new one. But it’s
The vast majority of AVD patients face an a serious operation and many patients are
harder to pump blood through the narrowed access problem. They remain stuck for too sick or frail to survive. For them, we turn
opening and the increased workload re- weeks or months at the family doctor level. to minimally invasive procedures, including
quires more blood to nourish the heart. They may go on to get the wrong test at the the transcatheter aortic valve implant (TA-
wrong place using the wrong technique. VI). Our team can perform the entire proce-
It significantly affects a person’s ability to Sometimes patients wait six to eight months dure in under 30 minutes.
function. With aortic valve disease, the
heart’s flow is capped. Even if the “tap” is on
full tilt, only a trickle of blood flows through.