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
Ottawa has sold its stake in Air Canada: sources
Two senior federal government sources have confirmed to CTV News that the federal government has sold its stake in Air Canada. During the COVID-19 pandemic in 2021, the government purchased a six per cent stake in the airline for $500 million as part of a bailout package.
Premiers disagree on whether Canada should cut off energy supply to U.S. if Trump moves ahead with tariffs
Some of Canada's premiers appeared to disagree with Ontario Premier Doug Ford on his approach to retaliatory measures, less than a day after he threatened to cut off the province's energy supply to the U.S. if president-elect Donald Trump follows through on his threat of punishing tariffs.
She took a DNA test for fun. Police used it to charge her grandmother with murder in a cold case
According to court documents, detectives reopened the cold case in 2017 and then worked with a forensics company to extract DNA from Baby Garnet's partial femur, before sending the results to Identifinders International.
Travis Vader, killer of Lyle and Marie McCann, denied day parole
The man who killed an Alberta couple in 2010 has been denied day parole.
McDonald's employee who called 911 in CEO's shooting is eligible for reward, but it will take time
More than 400 tips were called into the New York Police Department's Crime Stoppers tip line during the five-day search for a masked gunman who ambushed and fatally shot UnitedHealthcare CEO Brian Thompson last week.
Man who set fires inside Calgary's municipal building lost testicle during arrest: ASIRT
Two Calgary police officers have been cleared of any wrongdoing in an incident that saw a suspect lose a testicle after being shot with an anti-riot weapon.
Country star Morgan Wallen sentenced in chair-throwing case
Country music star Morgan Wallen on Thursday pleaded guilty to two misdemeanour counts of reckless endangerment for throwing a chair from the rooftop of a six-storey bar in Nashville and nearly hitting two police officers with it.
Weather warnings for hazardous conditions in parts of Canada
Canadians experienced contrasting weather on Thursday, from warmer temperatures in the Maritimes to extreme cold in parts of Ontario, the Prairies and the North.
Police say suspect in UnitedHealthcare CEO killing wasn't a client of the insurer
The man charged with killing UnitedHealthcare CEO Brian Thompson was not a client of the medical insurer and may have targeted it because of its size and influence, a senior police official said Thursday.