Max Morton was admitted to Vancouver General Hospital's emergency room with all the signs of a failing heart valve.
His blood pressure was crashing before his doctors' eyes, and he wasn't a good candidate for open-heart surgery. He'd previously had an artificial aortic valve put in, and it was failing. The signs of heart failure that usually cropped up over many days all started appearing within six hours.
He needed a valve replacement stat, but the mortality rate for patients who've previously had a valve surgery is 34%.
A heart valve replacement usually takes hours. Only Morton didn't have hours.
There was one option, but it had only ever been done with careful planning on patients who were in good condition — not crashing like Morton. The medical team decided to go for it.
It's called a transcatheter aortic valve replacement (TAVR). Here's how it works:
A catheter is inserted through the femoral artery in the upper leg.
The new valve is placed in the heart via that catheter, and a balloon expands it once it's in place.
The catheter is removed and the new valve stays in place, doing its job to keep regulating the flow of blood from the heart.
GIFs from Arizona PBS/YouTube.
While less invasive than open-heart surgery, TAVR usually takes a while. And it's usually planned in advance because it takes a big team effort.
Dr. David Rizik, an expert on TAVR, explained to PBS why it needs so many people. Essentially, it works best when you have an anesthesiologist, an echocardiographer, and a non-invasive cardiologist leading the work. But there's also backup staff, nurses and technicians, and an open-heart surgeon on standby.
It's the epitome of an all-hands-on-deck moment!
That's what makes it so astounding that Vancouver General was able to pull it off on the fly.
They had every piece of equipment and every type of professional needed to play each specific role in concert with each other.
Because of that preparedness, they were able to perform the procedure in 19 minutes!
The team made it happen! Max Morton and Dr. David Wood (center) with the team. Images from Vancouver Coastal Health, used with permission.
Dr. David Wood is the interventional and structural cardiologist at Vancouver General who led the procedure with his team. In an interview with CBC, he marveled at what this case could mean for hospitals everywhere.
"To be able to have people come in critically ill like this, mobilize a team, and fix a valve like this through the leg, in that short period of time, I mean — the sky's the limit now, truly."
Since the average survival rate for someone in need of a valve replacement "without surgical intervention is only 50 percent after two years and only 20 percent after five years," perfecting this kind of technology and making it more accessible is crucial to people not putting off treatment. In emergency cases, it's even more critical.
If other hospitals take a page out of Vancouver General Hospital's book, it could mean more success stories like Max Morton's.
Instead of becoming another statistic of heart disease, the 79-year-old fishing enthusiast was able to joke around about going out fishing about 20 minutes after his procedure.
Families everywhere need more happy outcomes like this!