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Image of Dr. John Webb with Gisela Wegner
(left) Interventional cardiologist Dr. John Webb with Gisela Wegner, the 1,000th patient to undergo a THV procedure at St. Paul’s Hospital. Valves, like the one shown here (inset left), are used in THV procedures to replace a patient’s damaged heart valve.

Heart Surgery Milestone


Dr. John Webb and his team at the Centre for Heart Valve Innovation at St. Paul’s Hospital continue to lead by expanding an innovative heart procedure

After a decade of heart trouble, 87-year-old Gisela Wegner’s aortic heart valve was starting to fail, no longer able to properly open to let her blood through the chambers of her heart. Simply bending down to pick something off the floor was an effort, and she couldn’t climb the seven stairs in her West Vancouver home without stopping multiple times to catch her breath. She was rarely without her puffer and suffered almost daily from debilitating chest pains.

“I’d reached a point where I really felt that life was coming to an end,” says Wegner. In fact, life was about to start anew for Wegner thanks to a groundbreaking, minimally invasive procedure pioneered by Dr. John Webb, director of interventional cardiology at St. Paul’s Hospital. What’s more, Wegner was about to become part of history as the 1,000th patient at St. Paul’s to undergo this life-changing procedure.

Revolutionary valve Replacement Procedure

Wegner’s transcatheter heart valve (THV) implantation involved inserting a thin tube with a replacement valve into the body through a small incision, then directing it to the heart through an artery. St. Paul’s Hospital has been regarded as a pioneer of these procedures since 2005, when Webb was the first in North
America to successfully complete one. THV procedures have proven to be a life-saving alternative for patients like Wegner, who have scarred or thickened heart valves, due to age or other conditions, that need to be treated but who might not survive the strain of open-heart surgery.

On June 5, 2014, Wegner became the 1,000th patient at St. Paul’s to undergo the procedure. She arrived at St. Paul’s on Wednesday afternoon, had the procedure early Thursday morning and was home by early afternoon the next day.

A Decade of Work

Since having a THV implantation, Wegner hasn’t had a single chest pain. She can also climb stairs and walk and move about without labouring for breath. “I feel really good,” she says. “The operation was a complete success!” In recognition of the milestone, Webb was asked to perform the procedure live – using a
unique video broadcast centre at St. Paul’s Hospital funded by donors to St. Paul’s Foundation. This technology enabled an international audience to view the procedure, along with hundreds of doctors and other health professionals at the 2014 Transcatheter Valve Therapies conference in Downtown Vancouver – the largest such conference in North America.

“This was the culmination of more than a decade of work,” says Webb. “today, after doing 1,000 procedures, we can say with some confidence that THV is an accepted, standard therapy for many heart patients.”

Groundbreaking Tradition Continues

Just one year earlier, Webb had presided over another milestone: the opening of the Centre for Heart Valve Innovation in June 2013. The Centre is a specialized research and teaching facility and global hub dedicated to the advancement of medical science in the highly specialized field of minimally invasive heart valve treatments.

With Webb at its helm, the Centre has already broken new ground. To start, about half of the procedures, including Wegner’s, are now performed on patients while they are awake, using local anesthesia. “This reduces the stress and risks of surgery, improves results, avoids complications and allows patients to go home sooner,” says Webb.

What’s more, in January 2014, a team from the Centre became the first in the world to implant a transcatheter mitral heart valve using the same minimally invasive techniques as those used in the THV . Physicians at the Centre are also performing a procedure for repairing leaky mitral valves using a special Mitra clip. These new procedures represent a major advance in transcatheter heart valve treatment, which, thus far, had focused on diseases of the atrial valve.

As of June 30, 2014, the Centre had performed more than two dozen successful mitral-valve operations.

Patient First Approach

The Centre for Heart Valve Innovation has all the latest technology and some of the brightest minds working within its walls. Yet, the THV program – a collaboration between St. Paul’s and Vancouver General Hospital under the aegis of cardiac Services BC – remains as patient-centred as all of the programs
at St. Paul’s.

“We use leading best practices to make sure that technological advances don’t outstrip the patients ability to keep up,” says clinical nurse specialist Dr. Sandra Lauck, who was a hands-on nurse during the first THV

“We ask our nurses to really get to know the patients because we are committed to helping them live better, not just longer.”

Sharing the Knowledge

Webb’s life-saving work is supported by a McLeod Family Professorship in Valvular Heart Disease Intervention at St. Paul’s, established thanks to a signifigant gift from the McLeod Family, along with a leading gift from an individual, and generous gifts from an anonymous Vancouver family and the Edwards Lifesciences fund. As an internationally recognized leader in transcatheter heart valve procedures – with the broadest experience in the world – Webb has taught the techniques he pioneered to health care professionals in more than 25 countries.

Webb and his team offer a three-day course at least once every month to up to 20 cardiologists from around the globe. And the 2011 launch of St. Paul’s Virtual Teaching Lab has allowed Webb to provide live feeds of the THV procedures (like Wegner’s) at St. Paul’s to medical professionals everywhere.
The ultimate aim is to make such procedures accessible to all those who qualify for them, regardless of geography.

All told, the health care professionals instructed by Webb and his team have gone on to perform a total of nearly 150,000 aortic valve replacements using his method.

In Canada, an estimated 25 hospitals are doing the procedure and close to 300 hospitals in the US are now using the technique. For his role in the development of what is considered one of the most important advances in heart disease treatment in the past 25 years, Webb was awarded the esteemed LifeSciences BC Innovation and Achievement Award in 2014.

“It’s a real honour,” says Webb, who was also recognized by media giant Thompson-Reuters as one of the top one per cent most-cited researchers in the world. Clearly, on the international stage, Webb is considered an elite-level researcher and cardiologist, as well as a pioneer of game changing heart disease treatments.

To Wegner and his other patients, he is nothing less than a lifesaver. “I am the beneficiary of a remarkable doctor and an excellent program,” says Wegner.
“I feel truly blessed.”