Cardiac Surgery – University of Ottawa Heart Institute

The Heart Institute is an international leader in cardiac surgery. We have among the lowest mortality rates and largest patient volumes throughout North America, particularly for high-risk patients. Our Cardiac Surgery program provides a model of surgical performance and expertise in which patient diagnosis, assessment, treatment, and follow-up involve a concerted team approach.

Through a tiny incision between the ribs, multiple healthy blood vessels are grafted onto arteries to bypass coronary blockages. The operation is conducted while the heart is beating. The standard open-heart method involves stopping the heart, using a heart-lung machine, and breaking the breastbone to open the chest. Only a few sites in North America perform this procedure, which requires specialized tools and training.

We specialize in heart valve surgical techniques--for reconstruction of valves instead of replacement--including mitral and aortic valve repair. Surgeons also perform complex aortic valve procedures using minimally invasive surgical techniques. The comprehensive Valve Surgery Clinic follows patients after surgery to ensure thorough follow-up care.

For patients suffering from aortic stenosis (narrowing of the aortic valve) who are not good candidates for surgery, TAVI offers a minimally invasive option. Our medical team combines the exceptional skills of a surgeon and an interventional cardiologist in performing this catheter-basedprocedure. This technique currently best suits the higher-risk surgical population.

The Heart Institutes first transplant was performed in 1984, and as many as 36transplants are conducted here annually. Transplant patients are seen in the Heart Function Clinic when their hearts are no longer strong enough to pump adequate volumes of blood. The Heart Institute helps set the standard for transplant procedures and protocols across the country as a leading member of the Canadian Cardiac Transplant Group. In 2012, the Institute performed its 500th heart transplant.

Left ventricular assist devices (LVADs) temporarily replace the hearts pumping action and are surgically implanted for patients with end-stage heart failure who are waiting for a heart transplant (known as "bridge to transplantation"). The device takes blood from the left side of the heart and pumps it back to the aorta, the major vessel in the body. An LVAD is used until a donor heart is available for transplantation or in patients who are expected to improve (known as "bridge to recovery").

In this procedure, surgeons manoeuvre miniature tools through a keyhole-sized incision to destroy, or ablate, a targeted area of the heart. The ablation effectively short-circuits troublesome nerve endings responsible for atrial fibrillation, the most common form of arrhythmia.

In some patients, blood clots that travel to their lungs do not dissolve as they should and block the flow of blood. Blood pressure remains high, causing a persistent strain on the right side of the heart. The result is a condition known as chronic pulmonary embolism or chronic pulmonary hypertension. The Heart Institute is the designated Canadian centre for pulmonary thromboendarterectomy (PTE),a complex surgical procedure in which blood clots that block pulmonary arteries are removed.

Like an inflated balloon, the wall of the aorta becomes thin and can tear (dissect) or rupture when it is stretched by an aneurysm. Aortic dissection or rupture requires immediate surgical repair. Patients with aortic disease are managed in the Aortic Clinic.

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Cardiac Surgery - University of Ottawa Heart Institute