Traditional “open heart” cardiac surgery involves a 20cm incision (or cut) in the middle of the chest to split the sternum (or breastbone) to gain access to the heart. After this type of surgery, most patients take up to 8 weeks to return to normal activity due to the time it takes for the sternum to heal.
In minimally invasive mitral valve surgery, a modified “keyhole” technique is used with a smaller incision (up to 6cm) in the side of the chest, and then special instruments and a camera are slipped between the ribs to perform surgery. Because the sternum is not split in this type of surgery, most patients have a quicker recovery time and are able to return to normal activities at an earlier time.
Jurgen Passage spent 14 months undergoing specialised training at one of the world’s pioneering hospitals in minimally invasive mitral valve surgery, Universität Leipzig Herzzentrum (University of Leipzig Heart Centre) in Leipzig, Germany in 2008-2009. He has been performing this surgery with an experienced West Australian team at the Sir Charles Gairdner Hospital since October 2009 and at St John of God Hospital, Subiaco since October 2012.
Currently this surgical approach is offered, when suitable, to patients requiring mitral and/or tricuspid valve repair or replacement and to patients requiring atrial septal defect closure. Some patients may not be suitable to undergo this type of surgery.
MitraClip® for Mitral Regurgitation
Some patients with mitral valve regurgitation (MR) are not deemed fit for surgery. In this situation consideration can be given to insertion of the MitraClip.
The MitraClip system includes a catheter-based device that is delivered to the heart through the femoral vein in the leg. The MitraClip therapy is designed to reduce significant MR by clipping together the leaflets of the mitral valve. This device is currently approved by the Therapeutic Goods Administration in Australia and is undergoing continuing evaluation in a clinical study of the MitraClip device in Australia and New Zealand. The primary objective of this trial is to evaluate the long-term safety, efficiency and economic value of the MitraClip system. The MitraClip device is available at the Sir Charles Gairdner Hospital after evaluation by a multidisciplinary team including Interventional Cardiologist Dr Eric Yamen, Echocardiologist Dr Christopher Finn and Assoc Prof Jurgen Passage. They were the first team to introduce this procedure in Australia, and commenced treating patients in March 2011. Jurgen Passage is the Australian Surgical Principal Investigator for the Abbott-sponsored trial of this device.
Currently, this procedure is only available in Western Australia at Sir Charles Gairdner Hospital after thorough assessment to ensure that surgery is not an option.