A first-in-Canada heart procedure

Dr. Gianluigi Bisleri performs a first-in-Canada heart procedure on Margaret Spurrell to treat an irregular heartbeat.

A first in Canada heart procedure FNL

Margaret Spurrell is calling St. Michael’s cardiac surgeon Dr. Gianluigi Bisleri her ‘guardian angel’ after a first-in-Canada heart procedure.

What made it groundbreaking was that it was a procedure on her heart – not inside it. And it not only resolved an existing condition, but protected her from future risk.

It’s all thanks to Dr. Bisleri’s work in a new kind of minimally invasive heart surgery that is reinventing the patient experience. It’s a technique that could significantly reduce hospital stays and recovery times.

“I’m the only one in Canada doing these procedures,” says Dr. Bisleri, who joined St. Michael’s Hospital in 2020.

Margaret, 76, was referred to Dr. Bisleri for an irregular heartbeat. It was no small irregularity. She suffered from atrial fibrillation – a condition Dr. Bisleri describes as “an electrical storm” in the heart.

“Your heart goes like a milkshake machine, up and down, up and down,” Margaret says.

She took blood thinners for the condition, but that in itself came with risk. She has a rare condition that causes blood vessels in her stomach to rupture and bleed. Blood thinners made it worse.

“The blood thinner was causing havoc,” she says. “I’d stay off blood thinner a few days or I could have a stroke, but it was making these things bleed faster. This is what they were concerned about.”

Her cardiologist had heard of Dr. Bisleri’s minimally invasive surgery and ablation – an operation to treat atrial fibrillation. If Dr. Bisleri could fix Margaret’s heart, she could get off blood thinners.

Traditionally, ablation requires open-heart surgery. That means cutting a patient’s chest open, stopping their heart, and using a lung-heart machine to take over the function of their heart and lungs during surgery. For patients, it also comes with the prospect of a permanent scar – something that may be psychologically distressing – and significant recovery time.

As a result, surgeons and patients consider open-heart ablations a drastic option. Surgeons tend not to do an ablation unless they have an additional cause to do open-heart surgery.

Both traditional ablations and Dr. Bisleri’s ablation technique are designed with the same goal in mind: To stop the “electric storms” of atrial fibrillation. But Dr. Bisleri’s minimally invasive approach requires just three, keyhole-sized incisions.

He uses a miniature probe to target a specific area on the outside of a beating heart and treat it with heat energy. That way he can address the problem area causing the “electric storms” while protecting the rest of the heart.

Dr. Bisleri told Margaret he planned to carry out an additional procedure to reduce her risk of strokes. Right after the ablation, he would use the probe to target an appendage on the heart that acts like a “cul de sac” for blood. That’s a problem. Blood can pool and clot, and if blood clots travel to the brain, they can cause strokes.

While he was operating, he would use the probe to attach a tiny clip to the outside of the appendage to prevent blood from pooling there.

“Dr. Bisleri, he was so relaxed and he sat with us and explained everything to us,” Margaret says. “I felt I was such in good hands. I thought if I had any chances, it’s here at St. Michael’s.”

When Dr. Bisleri told Margaret she would be the first person in Canada to have the combination ablation-and-appendage procedure, she wasn’t scared.

“I said to him, ‘Well, that’s great,’” she recalls. “If I can help the ones coming behind me by having this done – the younger ones and older ones that don’t have a chance – I feel good.”

Margaret went in for surgery on October 26, 2021. It was successful. She’s no longer on blood thinners. She has a little card with the date of her surgery that she carries around like a trophy.

Dr. Bisleri shares credit for the success of the operation with his colleagues at The Schroeder BRAIN&HEART Centre. He says they are making major advances in minimally invasive cardiac care.

“I think it is a way that we can offer patients the possibility to live longer and live better, reducing the possibility of suffering very serious conditions,” he says.

Margaret says she’s already proof positive of the value of this work.

“At my age and with my health issues, this was life-saving,” she says. “Dr. Bisleri is my guardian angel. The team, they’re second to none.”

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