Innovative keyhole technique

Traditional “open heart” cardiac surgery involves a 20cm incision in the middle of the chest to split the sternum (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 of up to 6cm in the side of the chest. The surgical 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 in this procedure 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 Subiaco Hospital since October 2012.

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 a leaking mitral valve, mitral valve regurgitation (MR), are not fit for surgery. In this situation, treatment with MitraClip may be possible.

The MitraClip system includes a device that is delivered to the heart via a thin tube or catheter through a large blood vessel in the leg, called the femoral vein.  The MitraClip is designed to reduce significant MR by clipping together the leaflets of the mitral valve.

Treatment with 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 was the Australian Surgical Principal Investigator for the Australian 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 and that MitraClip is technically possible.

TAVI  Transcatheter Aortic Valve Implantation

Some patients with a stiffened or blocked aortic valve, aortic stenosis, may be at higher risk with conventional heart valve surgery.  In this situation, treatment with TAVI may be possible.

TAVI involves implanting an artificial heart valve via a thin tube or catheter through a large blood vessel in the leg, called the femoral artery. The new artificial valve is then implanted within the native aortic valve.

TAVI is only offered to patients who have undergone thorough assessment by our St John of God Subiaco Hospital TAVI Multidisciplinary Team to ensure that it is the best treatment option and that TAVI is technically possible.

TAVI is performed at St John of God Subiaco Hospital with both an Interventional Cardiologist and Cardiac Surgeon present for the procedure.

Jurgen Passage has been accredited to perform TAVI by the Australian TAVI Accreditation Committee.