Cardiologists at The Royal Melbourne Hospital have broken new ground performing the BASILICA operation for the first time in Australia.
The surgery was developed in the US and uses a technique that prevents coronary artery obstruction during transcatheter aortic valve replacement (TAVR), a rare but often fatal complication.
While the TAVR has become common in recent years, a certain portion of high-risk patients are not able to undertake the surgery.
Twelve years ago, Roger Reinhardt had a new valve placed inside a leaking valve through open heart surgery. When the valve failed two weeks ago the 88-year-old had limited options.
In his case his coronary artery was located so close to the leaky valve that any attempt to replace it would push the leaflet over the coronary opening and block blood supply to his heart, a fatal complication.
“I was quite happy to go along with it, I haven’t got much to lose and I just hope other people benefit from it,” The 88-year-old grandfather said.
The BASILICA procedure offers a solution to the problem of coronary obstruction during TAVR.
Lead surgeon, Dr Matthew Brooks, completed the two hour surgery alongside his team, including cardiac surgeon Dr William Wilson and echocardiologist Dr Eliza Teo. The procedure has only been performed 100 times internationally.
Dr Brooks had studied the procedure but only had the chance to speak with the US team at the National heart, Lung and Blood Institute the week prior to Mr Reinhardt’s surgery.
“It’s yet to be performed in Australia, but there’s a lot of overlap with this procedure in terms of skills – after liaising with the team in the US we were confident we could do this procedure safely with a very positive outcome for the patient,” Dr Matthew Brooks said.
This new procedure will have an especially important role in patients who have had a past bioprosthetic aortic valve where coronary obstruction may be a life threatening complication of the TAVR procedure without the Basilica procedure.
Director of Cardiology, Associate Professor, Leeanne Grigg said because of Mr Reinhardt’s high risk of surgery, without this procedure he was likely to end up in palliative care.
“This procedure gives another option for patients, it’s really incredible and it’s great because it is the first in Australia and it’s very new worldwide, with only 100 known cases done, this is really early on and has big potential,” A/Prof Leeanne Grigg said.
The day after surgery Mr Reinhardt was able to walk, and was discharged only a few days later to continue his recovery with his family in Bairnsdale.
“I’m so privileged that they’ve had a go and it was successful,” Mr Reinhardt said.