Canadian cardiologist Dr. Neil Fam completed the world’s first mitral regurgitation repair surgery through the jugular vein, giving an 86-year-old woman with heart failure and few other options a new lease on life.
Using a Canadian-invented device, Fam conducted the catheter-based treatment through the jugular vein instead of the more traditional route, through the femoral vein. His patient had severe mitral regurgitation, a heart condition where blood leaks backward through the mitral valve upon contraction of the left ventricle. At the very least, mitral regurgitation can lead to high blood pressure. In the most severe cases, it can cause congestion in the lungs.
The woman also had severe heart failure that wasn’t responding to drugs. Along with her age, she was ultimately not a good candidate for invasive mitral valve surgery. However, the alternative - the traditional catheter-based approach through the femoral vein - wouldn’t work either, because the vein was blocked. Fam described the situation as being “locked out, blocked from accessing her heart.” The only option left, Fam decided, was to conduct a risky procedure where a catheter is guided through a tricky angle in the jugular vein.
Baylis Medical Company, Inc’s SupraCross RF Solution was what Fam turned to when he and the patient decided to go ahead with the procedure. Fam used a catheter to send a MitraClip through the jugular vein, all the way to the heart to repair the leaking mitral valve. The MitraClip technology is steerable and delivers radiofrequency to puncture the heart’s septum, which is required for the catheter to reach the mitral valve to make the repair.
As the patient recovered from the surgery, Fam saw no complications and no further heart failure.
"Given the success of this procedure, the door is open for future studies of the jugular approach for treating the mitral valve," he said. However, the procedure will only be for specific, high-risk patients with no other options.
Fam published a report of the successful procedure in the journal Eurointervention.