First-in-province heart surgery gives hope to Moncton family

A patient and a surgeon in Saint John have taken part in a first at the New Brunswick Heart Centre.

On Feb. 3, Dr. Zlatko Pozeg replaced a diseased heart valve in Crysta Giles, 53, with a new one that had been repurposed from her own body in an operation called the Ross procedure.

"It's important for us to be able to offer this best option for this particular group of patients," said Pozeg. 

The group in question includes younger patients, up to their 40s and 50s, who have aortic valve disease.

Traditional aortic valve replacements use either a mechanical valve or one made of pig or cow tissue. A younger person who gets one has a significantly reduced life expectancy, said Pozeg.

The Ross procedure uses a patient's own pulmonary valve, which is in turn replaced by a specially prepared one from a human cadaver.

It means the patient doesn't have to take blood thinners or other medication to deal with the foreign material inside them, said Pozeg.

And the technique has been perfected to last a lifetime, he said. 

It may be new to New Brunswick this month, but it was pioneered in the late 1960s, by Dr. Donald Ross, a South African-born British thoracic surgeon.

A growing body of data shows it restores normal life expectancy in otherwise healthy patients, said Pozeg. That's very important to someone like Giles.

"She needs to be around a long time for her children and her family," he said.

Giles lost her husband in 2019 to a cardiac issue.

"Learning that I myself had an issue was pretty hard to hear for all of us," said the mother of two.

She learned "quite by chance" there was something wrong with her heart, when she was getting urgent care for an atypical migraine and ER staff noticed she had a heart murmur.

She eventually was diagnosed with severe aortic stenosis was told something had to be done about it as soon as possible.

A 'no-brainer'

Giles was given information about surgical options and was encouraged to read up on them. It didn't take her long to conclude that the Ross procedure was the way she wanted to go.

It "seemed pretty much like a no-brainer," she said.

"I really didn't want to put my children through any more loss or any more stress," Giles said of the likely possibility of dealing with significant cardiac issues over and over again if she opted for traditional procedures.

Her kids felt "really good" about it, too.

"They thought, 'Oh, this is fixable. We can do something about this. And it's going to be OK.'"

Important advancement for the region

Despite it being unprecedented in the province, Giles said she had few reservations. She knew the Ross procedure had been done successfully elsewhere, and she knew the team at the heart centre also had a lot riding on it.

"It's important for us to advance heart surgery and technology here and demonstrate we are an innovative, avant-garde heart centre doing things that any other heart surgery centre in the world is doing," said Pozeg.

He personally has been learning about the procedure for about a decade.

"The people of the province really deserve to have this option available to them," he said.

"It's going to impact a lot of people," said Pozeg — especially those under 60 who have another 25 to 30 years of life expectancy.

Aortic valve disease is extremely common, said the doctor. Hundreds of procedures are done every year in Saint John to fix the problem. The projection is to do 20 or so Ross procedures per year, he said.

Planning for the first procedure started a couple of years ago, said Pozeg, with the support of an entire team at the health centre, including the leadership.

Giles came along at "a great time," he said.

'So much hope'

It's only been a couple of weeks since the surgery but Giles said, "So far, so good."

"I'm feeling better pretty much every day," she said, and better than she did before the operation. She's grateful her chest pain and palpitations are gone.

"Sometimes when I'm just sitting quietly, I'm like, 'Wow, my body feels so still.' It's a really nice feeling."

Six months from now she's hoping to feel "better than ever."

"I have so much hope right now," said Giles.

"I'm looking forward to the weeks ahead where I keep getting stronger and able to do more and more — especially as the weather gets nicer outside — with my family.

"I'm looking forward to that a lot."