Cutting-edge heart failure therapies

Three outcomes are possible for patients suffering from severe and acute heart failure: 

• A full recovery 
• End-of-life care (in critical cases) 
• Use of advanced therapies, such as those offered at the MHI 

Advanced therapies are intended for patients with life-threatening heart failure.  

When medication proves insufficient, there are two options that can extend a patient's life, either temporarily or permanently: 

1. A left ventricular assist device (LVAD) 
2. A heart transplant 

1. The left ventricular assist device (a mechanical heart pump): a life-saving technology

When a patient’s heart doesn’t pump enough blood to supply the body, a mechanical pump can be surgically implanted to maintain blood flow. The device can serve as a long-term or permanent solution or be a temporary measure while the patient awaits a heart transplant. This is what happens during the procedure:

• The device is implanted in the tip of the left ventricle and connected to the aorta. It draws blood from the ventricle and sends it to the aorta and throughout the body. In essence, it replaces the function of the failing ventricle.
• The pump is connected to an external controller powered by portable batteries through a wire that passes through an opening in the skin. The controller powers the pump and continuously monitors its performance. 

Although it involves a complex procedure, an LVAD extends the patient’s life and considerably improves their quality of life. In fact, most resume their usual activities in the following months.

2. Heart transplants: giving patients a second chance at life 

When all other treatments fail, a heart transplant becomes the final option for patients with severe and irreversible heart failure. This is what happens during the procedure: 

• The diseased heart is replaced by a healthy heart from a compatible donor.
• The new heart is connected to the main blood vessels to ensure proper blood flow. 

A successful heart transplant is the result of a multidisciplinary team’s meticulous work, constant self-review, and unwavering commitment to providing excellent care. Encouraged by its positive results, the MHI is working with other Canadian centres to establish a national registry in order to optimize its systems and share best practices on a global scale. 
 

Heart failure affects 3.2% of Quebecers. Unfortunately, access to cutting-edge therapies remains limited. 
 
For instance, out of the thousands of patients who could benefit from these cutting-edge solutions every year, fewer than 1 in 10 receives treatment. This alarming discrepancy can be explained by a lack of awareness of treatment options among both referring physicians and patients.
 
The Montreal Heart Institute has the resources and expertise required to bridge this gap and meet the demand in order to keep changing more lives.

How is the MHI working to expand access to advanced therapies?

• By raising widespread awareness
• By sharing knowledge
• By focusing on education and training initiatives 

As such, Dr. Pierre-Emmanuel Noly is an associate clinical professor in the Department of Surgery at the Université de Montréal’s’ Faculty of Medicine. 
 
The potential impact of this work is immense: 

• A decrease in the number of preventable deaths caused by advanced heart failure
• An increased life expectancy and improved quality of life for patients
• Prompt and efficient care for eligible patients