A “miracle” at the MHI

This article is adapted from the sixth edition of the Foundation’s magazine.

Nothing in Geneviève Binette’s life hinted at what was about to happen. She was physically active and a dance enthusiast, with no known health problems. When she started feeling unwell a few days before her 40th birthday, she wasn’t worried. Perhaps it was just anxiety, she thought. Still, she asked her mother, a nurse by training, to check on her. After taking Geneviève’s pulse, her mother whispered as calmy as she could, “I’m calling an ambulance.” This marked the beginning of an improbable and unexpected journey that would bring Geneviève to the Montreal Heart Institute.

Dizziness was the first symptom Geneviève experienced. She felt like she might faint, although she had no idea that something was wrong with her heart. The initial tests at the hospital showed she had severe ventricular arrythmia. Several attempts to resolve it through ablation were unsuccessful. By this time, her condition was going downhill fast. With no clear solution in sight, her mother requested an urgent transfer to the Montreal Heart Institute. That’s how Geneviève ended up here.

Geneviève was seen by two specialized teams at the MHI: electrophysiology and cardiac intensive care. Catheter ablation was tried again, but the arrythmia stubbornly persisted. At this stage, her heart rhythm was a major concern. Her physicians decided to induce a coma and place her on an ECMO heart-lung machine. 

Intensive care physician Martin Albert was put in charge of Geneviève’s case. “Her refractory arrythmia led to cardiogenic shock, which is why she required ventricular support,” explained Dr. Albert. After several unsuccessful attempts to resolve it with ablation and drugs, ECMO kept her blood pumping and bought them some time, although it hadn’t solved the underlying problem. 

In the days that followed, the situation deteriorated further. “We didn’t have very many alternatives, other than implanting a total artificial heart,” said Dr. Albert. But a TAH is an extremely rare and complex procedure. As for a transplant, there was the challenge of finding a compatible donor within a realistic timeframe. Dr. Albert explained that Geneviève was “alloimmunized.” In other words, the antibodies she had developed during her pregnancies made the risk of rejection very high, and the likelihood of obtaining a compatible heart was very low.

At this point, the team was at an impasse. They had the difficult task of informing Geneviève’s mother that they were running out of options. Unless an effective solution could be found, the outcome was inevitable: her heart wouldn’t last.

The decision was made to attempt a fifth ablation. Dr. Lena Rivard agreed to do the procedure. It was no easy feat: she had to locate the source of the arrythmia using a single catheter, since the ECMO machine made it impossible to insert any more. Dr. Rivard pulled out all the stops to save the life of the 40-year-old mother of three—a “Hail Mary” if there ever was one.

“And that’s when she located the arrhythmia and ablated it completely,” explained Dr. Albert. The team could then start weaning Geneviève off ECMO and let her heart take over.

She wasn’t out of the woods just yet. ECMO had triggered a rare complication: the venous cannula was significantly impairing blood flow in one leg, leading to extreme congestion. Dr. Raymond Cartier wasted no time: he performed a fasciotomy and vascular reconstruction to relieve pressure on the affected tissues and repair the blood vessels—crucial procedures that saved her leg.

When she was finally extubated, Geneviève was disoriented and confused. The prolonged coma and medications had left their mark, causing episodes of delirium. Her eyes were open, but she wasn’t fully responsive to her surroundings. Her neurological state remained uncertain for several days.

That’s when a simple act of kindness made all the difference. Mireille, one of the orderlies, knew that Geneviève was a dancer and enjoyed Latin music, so she played some bachata songs for her. Geneviève started to show signs of coming around: first a tear, then a smile. So they kept the music playing. By the next day, she spoke her first post-coma words.

There was still more to come, however. A few weeks later, an echocardiogram showed a pseudoaneurysm in the left ventricle, due to a perforation of the ventricular wall about 3 millimetres wide. The perforation had patched itself, but it left a thin pocket in the heart wall that could rupture at any time.

Dr. Michel Pellerin decided to reclose the perforation, although he let Geneviève recover a little longer before taking her back into surgery—a decision she and her mother greatly appreciated.

Geneviève was sent home over two months after admission. She had to relearn how to walk and build her stamina back up. But only a few months later, she was already on the road to recovery. 

It’s now 10 years since all that happened. Geneviève continues to go in for regular checkups at the MHI. She is still recognized by staff in the hallways, who remember her as a “miracle case.” She has changed careers and become a therapist. She still carries the profound effects of what she endured. 

The ECMO machine that kept her heart and lungs working at a critical time was acquired through a philanthropic donation. Without it, they would’ve run out of time before finding a solution. For Geneviève, the MHI Foundation is essential, providing support to medical teams and access to state-of-the-art equipment that preserves hope when options are limited. She learned that the ECMO machine that kept her heart and lungs working at a critical time was acquired through a philanthropic donation. Without it, they would’ve run out of time before finding a solution. That’s why she gives back to the MHI every year, purchasing tickets to the Bal des Grands Cœurs and the Après-Bal for herself and her mother. Today, she is dancing again and is overjoyed to have had the opportunity to be there as her children grow, thanks to the teams at the Montreal Heart Institute.

If Geneviève’s heart could speak, here’s what it would say: 

“You can do it. Be brave. Breathe. It isn’t as hopeless as it seems. Love and live every moment to its fullest, because you never know what tomorrow might bring.”