Historic keyhole heart surgery at St Vincent’s Private Hospital Sydney

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St Vincent’s Private Hospital Sydney has made history by performing keyhole surgery to repair a major artery near a patient’s heart.

Father of two Paul Foster had custom-made stents inserted through keyhole incisions in his groin and neck to mend the arch of his aorta.

The 46-year-old was one of the first in Australia to have the procedure done outside of clinical trials.

Associate Professor Ravi Huilgol, vascular surgeon at St Vincent’s Private Hospital, said it was cutting edge technology.

The stents, which are made of metal and covered in a fabric called dacron, are inserted into the damaged aorta to prevent it from rupturing.

“For a long time, the only other options for treating this were quite invasive – opening the chest cavity, stopping the heart, cooling the patient’s body temperature quite low,” he said.

“The advantage of this procedure, as well as being neat and nifty, is that is much less invasive and it allows the patient to recover much quicker.

“Mr Foster was the right candidate for the procedure as his aorta didn’t have a huge amount of plaque within the walls, lowering the risk of stroke.”

A/Prof Huilgol added that for a long time, the arch of the aorta had been a “frontier” of medicine.

“To have a solution to this that is standardised and much less invasive is really wonderful,” he said.

“It’s a viable option and its reproducible, which can’t be said for the other means we have used previously.”

Mr Foster’s condition was initially picked up while he was on a work trip in Brisbane earlier this year. He experienced a tearing sensation in his back which felt like he was being stabbed.

“They pretty much said, ‘if we don’t operate you are going to die’,” Mr Foster said.

“I guess I was walking around with a time bomb in my chest.”

Mr Foster had emergency surgery in Brisbane where a part of his aortic arch was repaired through open chest surgery, which required his ribcage to be cut open.

“For the first operation I was an absolute mess. I was in intensive care for four or five days,” he said.

“You can’t sneeze, you can’t cough. It really rips through your chest cavity.”

However, the new, minimally invasive procedure allowed Mr Foster to recover faster.

“Now I’m up and I’m moving it has been a really big difference,” he said.

“I had no family history of anything like this. I was doing five-kilometre runs before this.”

Dr Huilgol said he expected the minimally-invasive approach to halve the time it takes for a patient to be discharged from hospital.

The same technique has already been deployed for other areas of the body.

“We’ve got a lot of experience with using stents for aortic problems elsewhere in the body, further down in the lower thorax and abdomen, and a lot of experience using branched technology for those issues,” Dr Huilgol said.

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