When Dr David Wood was four years old his maternal grandfather, only 64, died of a sudden heart attack while chopping wood on the Sunshine Coast. That tragic event, combined with Dr Wood's later fascination with the workings of the human body, meant there was never any question that he would become a doctor specializing in the cardiovascular system.
"The heart is life, and everything to do with the heart — whether it is its function, the valves, the arteries — all of that is absolutely fascinating to me," says Wood, a structural and interventional cardiologist in Vancouver.
Dr Wood is a doctor making a global difference. He is leading ground-breaking work, internationally, in minimally invasive heart valve replacement. He and his mentor/now clinical research partner, Dr John Webb, of the Centre for Heart Valve Innovation at St. Paul's and Vancouver General Hospitals, developed the "Vancouver Clinical Pathway" - a much less invasive procedure for heart valve replacement that is set to revolutionize the operation around the world.
In the past, aortic valve replacement for the majority of patients was a major open-heart operation that "cracked the patient's chest," took more than three hours, required hospital stays of seven to twelve days and required up to eight weeks for patient recuperation.
The new Vancouver-perfected approach to transfemoral transcatheter aortic valve replacement (TAVR) is done with the patient awake and minimal or no procedural sedation. The new valve is threaded up to the heart through a small incision in the patient's groin and implanted inside the old valve, taking over its function.
In collaboration with Dr Webb and Sandra Lauck PhD, Dr Wood recently led a prospective 13-centre trial —11 sites in Canada and 2 in the US — where 411 patients were treated with the Vancouver clinical pathway. Nine of the 13 sites had never performed TAVR on awake patients or discharged patients in less than 2 days.
Amazingly, the average operating time in the study was only 30 minutes with 80% of patients going safely home the next day and 90% within 2 days. There were fewer post-operative complications and patients were up walking about only 4 hours after there valve had been replaced.
"Most patients go home the very next day! It is mind-blowing. Everyone is so excited because it is going to transform global care," says Dr Wood, 44.
Dr Wood's passion for what he does comes out in enthusiastic exclamations. His conversation is peppered with "amazing!" "incredible!" and "wonderful!" He says: "I love working with the team in Vancouver!"
Dr Wood credits much of his career trajectory to being "in the right place at the right time." But clearly he was the right person at the right time, too. He did his undergraduate medical degree, his internal medicine specialty and cardiology specialty at the University of BC —and was chief resident for both internal medicine and cardiology. (Chief residents are chosen for their exceptional clinical and leadership skills.)
In 2004-05 he was the chief cardiology resident when cardiologist Dr John Webb was doing the first transcatheter aortic valve implants —back then under general anesthetic, with patients still staying a number of days in hospital. "John has been a tremendous mentor and friend, now partner. He has been so incredibly supportive of all the initiatives we have done over the last decade and more."
Dr Wood spent a year, in 2008-09, in New York, working at the Lennox Hill Heart and Vascular Institute and then returned to Vancouver to help found the Centre for Heart Valve Innovation in Vancouver. "I am passionate about learning and teaching," he says.
That's fortunate, because now he is travelling almost weekly to teach the Vancouver approach to TAVR to medical teams around the world. This year he will be in countries like Spain, Germany, the Netherlands, the UK, and all across the US.
"We go and train a whole site, the entire care team, not just the cardiologist or surgeon, but nursing, imaging, anesthesiology. The team is crucial." The trained site becomes a centre of excellence and its people then train other sites in the region. "It is an incredibly useful approach to spread the technique," says Dr Wood.
Now 31 sites in Canada are doing TAVR and Dr Webb and/or Dr Wood have trained most of them.
As a father of four young daughters under the age of 12, he plans his travel so he can take a red-eye flight and be home as much as possible in time for their soccer practices and games. He coaches three out of his four daughter's soccer teams. "That's my passion outside of work. I love it!
The minimally invasive techniques are not just transforming aortic valve replacement, but new procedures are coming for mitral valves and tricuspid valves, too, as well as other heart procedures.
"Vancouver and BC has the opportunity to lead not just locally but nationally and internationally for the foreseeable future — which is pretty amazing!" he says.
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