Forgoing a heart transplant

Three years ago, Benoit Marcotte came into the care of the Montreal Heart Institute’s Transplant Clinic. On the agenda were close monitoring and monthly exams to ensure that he would be able to receive a compatible heart as soon as one became available. Two years later reality caught up with him. The transplant was no longer in his best interest. What happened? How did Mr. Marcotte see his future?

An encounter with an optimistic, resilient, and fun-loving man!

From a routine exam to the heart transplant waiting list

Until the age of 50, Benoit Marcotte had no idea he had a bicuspid aortic valve, a congenital defect that creates heart-damaging leakage. Completely asymptomatic, Mr. Marcotte discovered his condition during an employer-mandated routine exam. More precisely, his stress echocardiogram revealed certain irregularities: “My heart had already been affected. I took medication up until the age of 60, then I had an operation to install an artificial heart valve. I also have a pacemaker and a defibrillator. My heart is functioning at 40% of its capacity.”

A cardiologist monitored his status until the day that he noticed a decline in Mr. Marcotte’s condition and contacted the Montreal Heart Institute’s Transplant Clinic. That is how Mr. Marcotte’s name was added to the heart transplant waiting list. “When you’re waiting for a transplant, you’re in a permanent state of pre-op. I underwent many exams and kept taking my medication.” Two and a half years later, his condition is still stable.

Transplantation: an option that’s not always recommended

At 70, the patient met Dr. Normand Racine, the head of the Transplant Clinic. Dr. Racine believed that the risk-benefit ratio was no longer favourable to Mr. Marcotte because of his age. As such, the specialist advised him to remove his name from the waiting list. “Death is more common after a transplant at my age. And then, of course, you may have a new heart, but your body is still growing older and weaker. The longevity offered by a new heart has less impact.” This news came as a great shock. “For the last two and a half years, I was in good shape. My abilities were limited, but I was functioning. So I asked Dr. Racine what he would tell me if he were my son. He said: ‘I wouldn’t undergo this operation if I were you.’ That settled it for me.”

Since making this decision, Mr. Marcotte is doing well. He no longer has to attend multiple appointments and intrusive and non-intrusive exams related to the transplant. Simply put, this friendly retiree is enjoying his free time and the presence of his family. “I go swimming six times a week and I paint. That’s my hobby. And I’m very lucky, I have a wonderful family with three beautiful children and four grandchildren who are very close to me.” He might not know what the future holds since prognoses are, like the stock market, unpredictable, but he’s enjoying life to the fullest. “Now I’m hurrying to have fun! It’s good for my health and my immune system. So that’s what I’m working on!”

The Montreal Heart Institute: a human-scale institution

For Benoit Marcotte, having access to the Institute’s expertise is a real privilege. Be it the staff, the work organization, or the cutting-edge treatments, he is impressed by it all.

Teamwork above all else

“The cardiologists work in close collaboration with each other. I met several of them over the course of my exams, and each was as familiar with my file as if he or she were my primary physician. They carefully assessed my situation before each appointment, and they even meet each month to discuss developments in all the clinic’s records. It’s reassuring that everything isn’t resting on one doctor’s shoulders.”

This close-knit teamwork also shows itself in the absence of hierarchy between professionals from different disciplines. “You don’t get the impression that the nurse clinicians have a status different from the doctors. The nurses are 100% dedicated, they let us know the doctors’ conclusions and are on the frontline with them. You can tell they’re on an equal footing.”

A multidisciplinary approach is promoted within the team. “As a patient, you can see a psychiatrist, a nutritionist, or other specialist, depending on your situation. Everyone works together and everything is synchronized.” Same thing for appointments: no chance of a patient being seen two hours after his or her scheduled appointment time! It’s a finely tuned operation.

Compassion and empathy at the heart of our care

Our caregivers know their patients, care about them, and are dedicated to helping them in a compassionate way. “When you’re in a hospital gown, you’re feeling extremely vulnerable. You’re no longer a vice-president, or ‘dad’… we feel stripped of what we were before. And the human factor, be it the doctor’s hand on your arm or a word of encouragement, makes all the difference.”

Mr. Marcotte remarks that patients are grateful for the friendly and personalized treatment they receive, and that the employees themselves seem to enjoy working at the Institute. How inspiring for anyone who receives care at the Institute! “Don’t forget that you’re cared for by some of the best specialists in their field. You can’t ask for more.”

The Foundation: contributing to the evolution of care and research

In addition to patient care, the Montreal Heart Institute Foundation also allows the institute to continue its research mission. “I benefit directly from that,” acknowledges Mr. Marcotte. “One of the medications that I’m currently taking didn’t exist ten years ago, and it’s getting better all the time.” Without research, new treatments wouldn’t see the light of day, and patients like Benoit Marcotte wouldn’t be able to maintain their quality of life as long as they do.

To contribute to these innovations, the Institute and its Foundation gratefully accept donations from patients and their loved ones, as well as from members of the community. Want to get involved?