May 5, 2020

From Calgary to Gdańsk: Team teaches innovative heart surgery techniques in Poland

Minimally invasive procedure for aortic valve replacement expected to improve outcome for patients

Sharing knowledge is often a key part of the medical profession, especially in an academic environment. But a surgical team from the Libin Cardiovascular Institute recently went above and beyond in their commitment to improving outcomes for patients.

Last November, cardiac surgeon Dr. William Kent, MD, and a team of Calgary-based physicians visited Gdańsk, Poland to teach advanced cardiac surgical techniques.

They focused on teaching a minimally invasive approach for aortic valve replacement. Kent has been performing these operations since 2016, and believes they are superior to conventional open heart surgery for many patients. Although experience to date is limited, studies suggest that patients are released from the hospital sooner, have less pain and fewer complications with this surgical approach.   

“It’s a real benefit for recovery,” says Kent, a clinical assistant professor in the Department of Cardiac Sciences at the Cumming School of Medicine, noting patients can be more active earlier, with no restrictions on their mobility when they are discharged from the hospital.  

Libin team during surgery

The Libin Institute cardiac surgery team, headed by William Kent, prepares to perform a surgery in a hospital in Gdansk, Poland. The team visited the city to teach new surgical techniques.

Courtesy William Kent

Minimally invasive valve operations are performed through a five-centimetre incision between the ribs that gives surgeons access to the patient’s heart. Specialized instruments, designed to allow surgeons to perform their work in a confined space, are used to perform complex valve repair or replacement. This includes a videoscope, which projects an image of the valve on a monitor in the operating room.

Calgary connection in Gdańsk

Kent performed several aortic valve replacement operations at the Medical University of Gdańsk, alongside Polish cardiac surgeon and transplant specialist, Dr. Wojtek Karolak, MD, PhD. Karolak trained at several institutions in the United States and Canada and spends a few weeks every a year in Calgary working with the Libin Institute’s surgeons in the operating room.

His connections prompted Karolak to invite the Calgary team to teach the minimally invasive techniques in Gdańsk, where the surgical team performs about 1,200 operations each year, including lung and heart transplants.

“The visit was a huge help,” says Karolak. “It impacted every aspect of our program here, brought many changes and everyone met and loved meeting each other. I am personally very thankful. I know each person who came sacrificed their personal and professional time, and this is something I will be thankful for always.”

Kent says he is pleased with the outcome of the surgeries and notes his Polish counterparts are well on their way to implementing the new procedures on their own.   

Calgary’s minimally invasive program was started by Kent and Dr. Andrew Maitland, MD. Although most bypass operations and complex surgeries still require conventional open-heart surgery, Kent says half of the cases he performs are now completed using minimally invasive techniques.

Procedure a success

The Calgary program has been a great success, so much so that Kent has been invited to teach the procedure at numerous other sites in Canada.  

Eager to show the impact of the technique, Kent is conducting a study to compare conventional open-heart valve surgery with minimally invasive techniques. The study will assess standard outcome measures, such as complications and valve function, as well as other previously unevaluated qualitative outcomes, like patient-reported pain levels, mobility, respiratory function, quality of life and the length of time it takes patients to return to work. He is hoping to have early results of this trial, scheduled to begin in the fall of 2020, in 12 to 18 months.

As for the Polish-Canadian connection, Karolak is hoping to facilitate a long-term relationship between the two centres, with the potential for more educational trips to other countries that need the support.

Other members of the team that travelled to Poland include intensivist Dr. Ken Parhar, MD; anaesthesiologist Dr. Duc Ha, MD; and perfusionist Dr. Steve Menzies, MD.