XPost: can.politics, bc.politics, ont.politics   
   XPost: man.politics, sk.politics   
   From: ConsRCons@govt.cda   
      
   This is one of those 'wow' moments in Canadian medicine.  Anyone with   
   high blood pressure, leading up to heart problems should also be aware   
   of it.   
      
   Now, if they could only get the cartilage replacement thing advanced to   
   the point of making joint replacements unnecessary . . . .   
   _________________________________   
   CBC News Posted: Jan 01, 2014   
      
   Montreal Heart Institute hits milestone with new surgical technique   
      
   With 500 operations now behind them, doctors set to teach minimally   
   invasive surgery worldwide   
      
      
   A surgical team at the Montreal Heart Institute recently operated on its   
   500th patient using a minimally invasive technique that it predicts will   
   revolutionize heart surgery.   
      
   To a layman, the procedure appears impossibly clumsy – like performing   
   surgery with long metal chopsticks.  However, Dr. Michel Pellerin says   
   the instruments, which include a tiny camera capable of great   
   magnification and specially modified surgical tools, provide huge   
   benefits for the trained surgeon.   
      
   "You see really well the [faulty] valve," Pellerin says. "It's really   
   highly magnified, so you can see precisely what are the problems."   
      
      
   Michel Pellerin   
      
   Dr. Michel Pellerin of the Montreal Heart Institute describes the   
   minimally invasive procedure he and his team have been perfecting for   
   mitral valve repairs and other cardiac surgery. (CBC)   
      
   The main benefits, however, are for the patient. Where open heart   
   surgery requires a long incision down the centre of the chest, the   
   procedure employed by Pellerin and his partner, Dr. Denis Bouchard,   
   involves a small incision in the right side of the chest. There is   
   little obvious scarring, little pain during recovery and recovery is   
   much faster, which means shorter hospital stays.   
      
   Eight years after sending a team member to Belgium to learn the   
   technique for mitral valve repairs, Pellerin and Bouchard are now using   
   the minimally invasive approach to perform a whole range of valve   
   repairs and replacements as well as other operations to repair heart   
   defects.   
      
   "It's truly the first approach here at the Heart Institute," said   
   Bouchard, the director of cardiac surgery at University of Montreal. "We   
   can now aim at close to 150 to 250 minimally invasive surgeries a year."   
      
     A less invasive procedure also means surgery becomes an option for   
   elderly patients with heart disease who might not be able to survive a   
   more traditional approach.   
      
   In November, Bouchard performed minimally invasive surgery on an   
   89-year-old woman.  A month later, the elderly patient walked briskly   
   into his outpatient clinic as if she had never had surgery.   
      
   "That's one month after surgery," said Bouchard. "That's something we   
   have never seen before...Severely ill patients at an advanced age that   
   can go through the surgery as if they were going through a hernia   
   repair.  It's really amazing."   
      
      
   Quick, painless recovery   
      
   More typical is Emile Sadaka's experience.   
      
   The 54-year-old contractor is a cycling enthusiast, but five years ago,   
   a congenital heart defect that left him with a murmur started slowing   
   him down.   
   Emile Sadaka   
      
   Emile Sadaka indicates the spot where his surgeon made a tiny incision   
   for his minimally invasive surgery to repair a mitral valve defect. (CBC)   
      
   "The more I trained, the worse it got," Sadaka said. "It got to a place   
   where I actually couldn't train anymore."   
      
   Traditional open heart surgery to repair his defective mitral valve   
   would have meant months off the bike – and off work, something the   
   entrepreneur did not want and simply couldn't afford.   
      
   Sadaka's surgeon, fellow cycling enthusiast Michel Pellerin, suggested   
   the minimally invasive approach.   
      
   "I was basically back on my bike in a month," Sadaka recalls. "I was   
   back training within six months."   
      
   Two years later, he climbed Mont Ventoux – one of the toughest   
   challenges on the Tour de France cycling circuit.   
   Clinical studies underway   
      
   Pellerin and Bouchard are convinced minimally invasive surgery will one   
   day be recognized as the gold standard. However, they still need to   
   prove that to their fellow surgeons, and a number of clinical studies   
   are now underway.   
      
   "I see the patients in my office, and there is no doubt that they   
   improve much, much faster," says Bouchard. "But does it mean they go   
   back to work two months earlier, one month earlier, two weeks earlier?   
   Does it mean they have a major decrease in post-operative pain, or a   
   slight decrease?"   
      
   "These are things that we must publish properly to convince [other   
   surgical] centres and to convince healthy policy makers that [this   
   approach] is worthwhile."   
      
   Scores of visitors from all over the world have visited the Montreal   
   Heart Institute and watched the procedure. Later this year, the   
   institute will launch a new international master's program, in   
   collaboration with centres in Belgium and Italy, to train more surgeons   
   in the technique.   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)