In the wake of performing a record-breaking three heart transplants within 24 hours, Dr. Anson Cheung, director of Cardiac Transplant and Mechanical Circulatory Assist Program of BC at St. Paul’s Hospital, is humble. He’s quick to praise his fellow surgeons and cardiologists as well as the anesthesiologists, perfusionists, nurses and other OR staff, the team in the CSICU as well as the “incredible effort” put forth by BC Transplant in helping to coordinate what was a first-in-BC medical milestone.
“This took a great deal of coordination between a lot of people,” says Dr. Cheung. “Our team here at St. Paul’s and the team at BC Transplant, the families of the organ donors, the families of the recipients. Many different people helped to make this day possible.”
23 Hours in the OR
Not including preparation, from the beginning of the first surgery at 6:00 p.m., to the end of the third at 5:00 p.m. the following day, Dr. Cheung clocked 23 hours in the OR.
The first transplant began at 6:00 p.m. and took three hours to complete, with Dr. Cheung closing at 9:00 p.m. A mere hour later, the second, more complicated procedure took place overnight, lasting seven hours and closing at 5:00 a.m. After a rest, the final transplant started at noon and was completed by 5:00 p.m.
The variation in procedure length relates to the unique circumstances of each patient. For example, a transplant for a patient with a condition like congenital heart disease is more complex and requires more time. Of the three procedures, the second and third were more complicated; the third had an existing ventricular assist device (VAD) implanted and the new heart necessitated its removal. To remove a VAD adds time and complexity to the procedure.
Each surgery was staffed with fresh OR personnel as per the usual hospital staff rotation, so the entire team was at full capacity and alertness.
If you’re wondering how Dr. Cheung got through such a long day, he says he felt mentally and physically fine, which he attributes to being “in the moment” and to being “in the flow” of the busy operating room. Additionally, he was able to get some sleep during the seven-hour window between the second and third procedures.
But his work didn’t end there. Dr. Cheung had another surgery scheduled for the following day.
Dr. Cheung reports that all three procedures went smoothly and the patients are doing fine.
Transplants on the Rise
Between 2010 and 2014, St. Paul’s – the only hospital in BC that performs adult heart transplants – performed an average of 19 transplants per year. In 2016, 20 transplants had already been performed by the end of August. The 2007 single-year record of 23 heart transplants could be defeated if the trajectory continues.
The number of transplants performed at St. Paul’s depends on the number of donor organs that become available.
To support the lifesaving work of the provincial Heart Centre at St. Paul’s, please contact St. Paul’s Foundation at 604-682-8206 or visit helpstpauls.com.