New technology reduces need for open heart surgery

In an Australian-first for children, doctors have used a new technology to perform a minimally invasive cardiac procedure on two children at The Children’s Hospital at Westmead, saving them from needing open heart surgery and drastically improving their recovery time.
The innovative technique, known as a self-expanding large diameter transcatheter pulmonary valve replacement (TPVR), is used for patients with congenital heart disease whose pulmonary valve, which controls the blood flow from the heart to the lungs, is failing.
Traditionally, valve replacement for most patients required cutting through the chest bone and placing patients on heart-lung bypass with management in intensive care for recovery. The self-expanding large diameter TPVR avoids this by allowing doctors to replace the pulmonary heart valve using a vein in the leg to access the heart.
“Before we were able to offer self-expanding large diameter TPVR, most children needing a pulmonary valve replacement needed to have repeated open heart bypass operations approximately every 10 years. They faced lengthy recovery times, scarring, and were more susceptible to other complications. This procedure removes almost all those impacts," Dr Philip Roberts, Interventional Cardiologist at Sydney Children's Hospitals Network said.
The technique reduces the risk of complications from surgery, decreases post-operative pain, and fast tracks recovery time, with most patients able to return home within 24 hours.
The game-changing procedure was performed by Dr Philip Roberts, Interventional Cardiologist at Sydney Children’s Hospitals Network and his team in the Heart Centre for Children, with support from US device experts.
“The ability to offer minimally invasive procedures like this will lead to better health outcomes for children in NSW, allowing them to spend less time in hospital and more time at home with their families, where they belong," NSW Minister for Health Ryan Park said.
Fourteen-year-old Aurelius was one of the first patients to have a TPVR using the new technology. Aurelius needed his pulmonary valve replaced after being born with Tetralogy of Fallot (TOF), a condition that changes the way blood flows to his heart.
The procedure was successful and after one night in hospital, Aurelius was able to return to his home in regional NSW.
“This procedure has significantly transformed Aurelius’s life. When Aurelius was 13 weeks old, he needed to have an open-heart surgery and seeing the difference between the recovery then and the recovery now is just incredible," Kathryn, Aurelius's mum said.
More than 15 patients are expected to benefit from the self-expanding large diameter TPVR procedure each year in NSW.