Minimally Invasive Heart Surgery
Traditional open heart cardiac surgery is performed via an incision in the middle of the chest to split the sternum (breastbone) to gain access to the heart. Most patients take up to 8 weeks to return to normal activity, due to the time it takes for the sternum to heal.
Minimally invasive heart surgery uses a modified keyhole technique with a smaller incision (up to 6cm) in the side of the chest. 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 in the public sector since October 2009 and at St John of God Subiaco Hospital since October 2012.
This surgery is offered to suitable patients undergoing mitral and/or tricuspid valve repair or replacement, and to patients requiring atrial septal defect closure. Some patients may not be suitable for this type of surgery.
MitraClip® for Mitral Regurgitation and Mitral Valve-In-Valve
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.
Jurgen Passage was a member of the first Multidisciplinary Heart Team to perform this procedure in Australia in March 2011. Jurgen Passage was the Australian Surgical Principal Investigator for the Australian Abbott-sponsored trial of this device.
The MitraClip procedure is available at St John of God Subiaco Hospital.
Jurgen Passage also participates in the Multidisciplinary Heart Team that evaluates patients for potential valve-in-valve procedures in cases when bioprosthetic (artificial tissue) valves deteriorate or fail after surgery.
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 patient's own aortic valve. TAVI is also a potential treatment in cases when bioprosthetic (artificial tissue) aortic valves deteriorate or fail after surgery.
TAVI is only offered to patients who have undergone thorough assessment by our TAVI Multidisciplinary Team to ensure that it is the best treatment option, and that TAVI is technically possible.
Assoc Prof Passage is a member of the TAVI Heart Team at St John of God Subiaco Hospital and Fiona Stanley Hospital.
Jurgen Passage is accredited to perform TAVI. He is also a member of the Cardiac Accreditation Services ATVT Accreditation Committee, which is responsible for accrediting TAVI practitioners in Australia.
