Toronto General Hospital using new alternative to open heart surgery for biopsies
Doctors at the University Health Network have started to use a minimally invasive technique, previously used on lung patients, to carry out biopsies on patients with a mass needing diagnosis in their hearts.
Susan Bell was one of those patients.
After a medical technician detected something unusual in her heart during a routine checkup last fall, Bell underwent more testing only to find out she had a large mass right in the middle of her heart.
"Nobody had ever dealt with this type of tumour," she says. "It's right in the centre part of my heart, in the wall…The complexity, the location and the size made it a really rare (thing)."
Bell's doctor told her she would need open heart surgery to biopsy the mass and determine if it was cancerous.
But he also happened to be attending a medical conference around the same time. So, he presented Bell's case and asked for alternatives to biopsy the tumour.
A colleague of his from Toronto General Hospital (TGH), Dr. Patrik Rogalla, was also there and offered to do a minimally invasive procedure to get a sample of the tissue from the heart, which he had previously done to obtain lung tissue samples.
But the heart, says Dr. Rogalla, is quite different from the lungs.
"It is relatively easy for most people to hold their breath for a few seconds, during which we can do the sampling procedure and can take the tissue from a target," says Rogalla. "But we can't ask the heart to stop beating!"
This past April, Bell's physician, cardiac surgeon Dr. Robert Cusimano, and Dr. Rogalla, performed a minimally invasive biopsy on Bell while she was wide awake.
She was given a local anesthetic and a sedative but kept conscious so she could follow instructions, like holding her breath at certain points to minimize the movements of the chest, if not the heart itself, as much as possible.
No real incision was made, only a one-millimetre wide needle, inserted to take out a couple of tissue samples from the mass in Bell's heart. The procedure involves manually synchronizing a computerized tomography (CT) scan and fluoroscopy with the electrocardiogram (ECG) to collect the sample safely.
"They took the samples out and I had the results within three days," says Bell. "And I had absolutely no recovery (period), just an hour recovery at the hospital and other than that, I was on a plane and playing golf the next day."
Dr. Rogalla points out that some cases will still require open heart surgery for biopsies. But for cases like Bell's, the ability to avoid the surgery with its risks of infection, general anesthetics and lengthy recovery make this new procedure a clear benefit.
Plus, he points out, open heart surgery is very costly. The traditional procedure would cost just under $7,000 and require several days in the hospital, including a day and a half in the intensive care unit.
Bell went home the same day.
The biopsy showed her mass was simply a fatty tissue in her heart, and no further treatment was required. However, they will continue to do scans to monitor the mass for any changes.
Dr. Rogalla says in the near future, Toronto General Hospital could perform this 20 to 30-minute procedure on about 30 patients yearly.
And while TGH is the only hospital in Canada he knows of currently doing this technique for heart biopsies, he sees no reason others could not use it.
CTVNews.ca Top Stories
NEW Inside Canada's chaotic response to avian flu
A CFIA official is calling it the 'largest animal health emergency that this country has ever had to face.' A joint IJF/CTV News investigation looks into Canada's response to the bird flu pandemic, and how it's ravaged the country's farms.
What Donald Trump's election victory could mean for Canada
Following president-elect Donald Trump's decisive election victory, there are sure to be significant knock-on effects for Canada. Here's a look at the different areas in which a second Trump presidency may affect Canadians.
Cuba left reeling after Category 3 hurricane ravages island and knocks out power grid
Cuba was left reeling Thursday after a fierce Category 3 hurricane ripped across the island and knocked out the country's power grid.
Influencer is banned from future NYC marathons for bringing a camera crew to last weekend's race
A social media influencer from Texas was disqualified from last weekend's New York City Marathon and banned from future competitions after he ran the race with a camera crew on e-bikes in tow.
Sleepy during the day? You may be at higher risk for a pre-dementia syndrome, study finds
If you find yourself sleepy during your daily activities in your older age, you may need to consider it more than an inconvenience — since the fatigue may indicate you’re at higher risk for developing a condition that can lead to dementia, a new study has found.
Kamala Harris concedes: Here's what she said in her speech
Democratic Vice-President Kamala Harris conceded the U.S. election to Republican Donald Trump Wednesday afternoon, telling her supporters that her 'heart is full.'
Canada's health-care spending expected to outpace economy in 2024: CIHI
The Canadian Institute for Health Information says health-care spending in Canada is projected to reach a new high in 2024.
Newfoundland hockey player suspended, banned from local arena after off-ice fight with fan
A combination of a thrown stick and thrown punches have given a senior hockey player in Newfoundland a three-game suspension and an indefinite ban from one of his league's six arenas.
B.C. court allows police to apply to dispose of evidence from Robert Pickton's farm
The B.C. Supreme Court says it has jurisdiction to order the disposal of thousands of pieces of evidence seized from Robert Pickton's pig farm decades ago, whether it was used in his murder trial or not.