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I now have the honour of being the President of the Alumni and take the helm from Denny Doucette who so ably steered the Board and continues to contribute actively in his new role on the Executive Committee as Past President. Leaving the Board as their term concluded were Gene Szabo, Vice President, Jim Phillips, Past President, both highly dedicated volunteers who have contributed greatly to the success of the Alumni over the past decade. Their insights and many overarching contributions are highly appreciated by all of us who have benefited from their wisdom and relentless efforts. Directors Louise Guilbault, Board Secretary, Scott Chamberlain, Eric Breton, and Lise Martens have also left their mark on the Board, and we wish them well as no doubt they will continue to volunteer their time to other worthy causes. Angèle Ross who worked with our founder, Mary Clinckett, and succeeded Mary as Executive Director in 1991, has retired from that position. Her current workload with the UOHI Department of Anaesthesiology has grown substantially and she could no longer accommodate the increasing workload that the Alumni represented. Fortunately, we will have the benefit of her help in transferring her duties to her successor as well as looking after certain matters that require her contacts and experience. There will be more information provided on "Angie as we honour her monumental work over a 20-year period! These individuals truly represent the utmost dedication to the Alumni and the Institute and demonstrated volunteerism at its best. Thank you so much on behalf of all our members and the Board of Directors. As you no doubt appreciate, we have many vacancies in our midst. Our request for volunteers has received excellent response with some 12 talented additions. Early in January we held an Orientation Workshop to introduce them to our plans, operations, and provide an opportunity for each to identify their preferred roles, given their interests, abilities, and time availability. We are now working on integrating them into our operations. Thank you everyone who responded, you are very important to the ongoing success of the Alumni. From the "Big Picture" perspective, the Board is addressing the following key activities, based on our Long Range Plan:
We are working diligently on these three initiatives and I look forward to reporting to you on the accomplishments. As always, your input is warmly welcomed and no doubt will help us accomplish our goals. I hope that you will find this Bulletin and the Fall one of great value as both issues will contain considerable information on preventing cardiac problems. We are grateful to the management and staff of the Heart Institute's Minto Prevention and Rehabilitation Centre whose senior staff eagerly provided us with the information on which the Bulletin articles are based. I would also like to thank Ellen Corkery-Dooher who wrote the excellent articles.
Spring Lecture - April 24, 2008
Have you ever wanted to take part in a research study? HIPRC has received funding from the Heart and Stroke Foundation of Ontario to complete a study focused on family members of patients who have been treated at the University of Ottawa Heart Institute (UOHI) in the last five years. If you are a family member of one of these patients, and do not suffer from heart disease, you may be eligible to take part in this study. We had the opportunity to discuss the study with Dana Riley, the Research Coordinator and a PhD candidate in Population Health at the University of Ottawa. The study known as Family Heart Health is based on the premise that family members may share many of the same risks: genetic, biochemical, or similar lifestyles which may increase their risk of heart disease. As Dana noted, many of us often think it is "time to do something about preventing heart disease" when someone close to us has been treated at UOHI. The goal of the study is to learn more about how family factors affects heart health and to gather information about programs aimed at reducing these risks. Who is eligible to participate? Generally speaking, brothers and sisters, children and spouses' patients admitted to UOHI in the last five years may be eligible. Participants must be between the ages of 20 and 80 and have one or more risk factors related to heart disease - such as being a smoker, having high blood pressure or cholesterol, or abdominal obesity. If you meet these criteria and are interested in being considered, you can make an appointment for a screening interview. The screening appointment will take about 60-90 minutes and is completed at UOHI. It will involve completing a questionnaire, having a fasting blood test and providing several measurements (e.g. height, weight, blood pressure) to build your risk factor profile. Dana indicated that after this stage it is very rare for anyone to be screened out - it usually happens earlier in the process. If you are screened into the study, you will be randomly assigned to one of two groups: "usual care" or the Family Heart Health program. The usual care program includes standard information which provides information on opportunities to pursue self directed changes related to risk factors. For those assigned to the Family Heart Health program, participants will receive a personalized risk factor modification program supported by motivational behavioural counseling over the phone for a 12-week period. Everyone in the study will be followed up at three months and a year. At these appointments, participants will complete questionnaires, have measurements taken and have a fasting blood test completed to track their progress. The goal of the study is to learn if there is a difference between the two programs and to contribute to a better understanding of family heart health.
It is a real opportunity to contribute to some important research and take charge of your health in a meaningful way. Dana L. Riley, M.A.
Those of you who have been benefited from the Heart Institute's Prevention and Rehabilitation Centre may recognize its Associate Director, Dr. Robert Reid. He has been involved with the Heart Institute since 1989 when he was the case manager for Heart Check. Since then Dr. Reid has witnessed and contributed to the evolution of heart prevention programs with the support of his growing team. From the early days of offering risk factor screening to the public, Dr. Reid has worked diligently over the past 18 years to significantly expand the options available to us. These now include the development and implementation of lifestyle programs such as Smoking Cessation and community outreach programs that now offer the Heartwise exercise and rehabilitation regimen. You may not be aware of this, but Dr. Reid shared with us that the Heart Institute Prevention and Rehabilitation Centre (HIPRC) is one of the three or four largest centres of its kind in North America. By virtue of the sheer volume of people it serves every year and the very comprehensive nature of its services, HIPRC is the leader in its field. There are three main elements to HIPRC programs: Rehabilitation; the Heart Health Education Centre (HHEC); and the HIPRC research portfolio. The focus of HIPRC is to reduce the burden of heart disease in the Champlain region by working with those who have heart disease as well as those who do not. HIPRC offers clinical services which include rehabilitation programs for patients after they have been treated for cardiovascular disease. While rehabilitation was once offered on physician referral, we learned that the practice now is a system of automatic referral for patients after they have had angioplasty, a bypass or other treatment. Dr. Reid emphasized that rehabilitation is the first step in a standardized "clinical pathway", a quality management tool aimed at standardizing treatment and improving outcomes. The public at large can self-refer themselves for the smoking cessation program. This truly facilitates the accessibility of the program and hopefully will be an important element to the reduction of heart disease. Not surprisingly, HIPRC focuses on population health by undertaking public education activities through the Health Heart Education Centre, a multimedia education facility (please refer to our last Bulletin for a more comprehensive article on the HHEC). Recognizing that HIPRC is only a part of a much larger effort to foster heart disease prevention, Dr. Reid told us that HIPRC also serves as the secretariat for the Champlain Cardiovascular Prevention Network which includes primary care facilities, community agencies and the Heart and Stroke Foundation. Research has expanded dramatically to respond to need. It is focused both on the rehabilitative effect of different clinical approaches, as well as on preventing heart disease in the population. For example, HIPRC completed a survey on parental attitudes towards childhood obesity. HIPRC had 15 full-time researchers on staff at the time of the interview, most of whose work is funded through "soft funding" or grants. In the last three years the annual number of patients who received rehabilitation services at HIPRC has doubled to 2,300. Even more remarkable is the yearly demand for prevention services: 2,000 patients a year participate in smoking cessation programs, another 5,000 are reached through the network, and some 3,000 to 4,000 individuals are informed through lectures, workshops and telephone calls. These numbers don't even reflect those of us who access information and services online. Dr. Reid shared with us that HIPRC has found that people who live more than 30 to 40 minutes away are not likely to use the available rehabilitation programs and services. This raised a key question for staff: how could they reach these patients? As a result, Dr. Reid told us about the development of alternative styles for rehabilitation. On-site options can vary by length, ranging from a two to three contact triage resulting in a program the patient can follow at home in the community to one, two or three month programs on-site. The case managed home program is delivered entirely by phone, providing access to a range of nutritional, exercise, psychosocial and other services. Finally, through the Heartwise exercise program, HIPRC works with community based recreation providers to offer safe heart wise programs. If interested, you might consult your local community centre for information on these programs that are offered through the City of Ottawa at a reasonable cost. One of the many challenges faced by HIPRC is the demand for service which is growing at 15 to 20 per cent per annum. The main demographic is around age 61; baby boomers are starting to have their first cardiac events, driving the demand for service. Dr. Reid indicated the focus is not only on alternatives, but on how to expand HIPRC services, which is driving a lot of the research. For example, HIPRC researchers are exploring various approaches to rehabilitation, including an Internet based program known as Cardio Fit as well as a telephone solution. At the same time, the Centre is also expanding the capacity of communities to meet their needs through programs such as Heartwise and in responding to those seeking advice from HIPRC. The Alumni have made their own significant contribution to HIPRC said Dr. Reid. Donations have been used to upgrade the equipment at the rehabilitation centre including replacing the track, as well as integrating patient information across the UOHI, ensuring the material provided to patients and their families (e.g. booklets used after heart attacks or PCI) sends consistent messages and provides up-to-date information. The UOHI alumni continue to play an important role and their generosity has paved the way for even better service for the next group of patients. When asked about the main accomplishments in the last five years, it was clear that there have been many. Dr. Reid spoke enthusiastically to us about the Smoking Cessation program - the "real jewel of what we are doing". Known as the "Ottawa Model" the program is used by seventeen hospitals in the region and ten other hospitals in Ontario. The Centre has currently been funded to expand the program to British Columbia and New Brunswick, taking it "national". Dr. Reid indicated that the focus is not only on today, but on how to deliver services in the future. He expects patients to be even more comfortable with the many alternatives that will be available. HIPRC is trying to respond by undertaking research to ensure they can offer effective services that are more "on demand, on your own time". Dr. Reid commented, by way of example, that they will be streaming audio and video content. But he also stressed the importance of maintaining contact with people. In the end it was clear from our interview with Dr. Reid that HIPRC wants to expand its reach by offering us a range of options - and that staying connected to those who use these services is an important part of the equation. If you are interested in learning more about HIPRC visit them on the web at www.ottawaheart.ca/UOHI/PP_Home.do where you will find information about the team, their services and the HHEC, call (613) 761-5000 or visit HIPRC on the second floor of the University of Ottawa Heart Institute located at 40 Ruskin. We also encourage you to visit the Alumni website at www.ottawaheartalumni.ca/news/index-e.html where we provide a link to the HHEC schedule of lectures as well as other information on recent developments.
Earlier in the year, we e-mailed a brief questionnaire to some 900 members who were good enough to provide us their e-mail addresses. We thank the significant number who responded and thereby a new two-way communications bridge has been established. More recently we followed up with a second e-mailing to find more volunteers. Once again, we had a satisfying response demonstrating members' willingness to help the Alumni and the UOHI. The results of these mailings had also helped to update our records as a significant number of you have either moved to a different ISP or our records were incorrect (for which we do apologise). We are committed to continuously strengthen two-way communications so that we can best represent you and to quickly keep you apprised of developments. It would be most helpful if you could get in touch and give us your current e-mail address - to either correct a previous one or to join our growing E-mail List. Being on the OHIA E-mail List allows you to receive information much faster than waiting for our semi-annual Bulletin to be delivered. It will also help the Alumni save considerable printing and mailing costs. Corrected and/or new email addresses can be sent to our Secretary-Treasurer (E.J. (Ted) Legg) at ejlegg@cyberus.ca. To save time, please put "Corrected" or "New" OHIA Email Address in the Subject heading. Thank you very much for your consideration of this important communication matter.
By Gene Szabo
As many of us Alumni are golfers, why not take advantage of a great day of golf. You will have a great time, meet some interesting people, be dined and entertained and at the same time support both the Heart Institute and the Alumni. This year's tournament is being held on May 29, 2008 at the Canadian Golf and Country Club with registration at 11:00 a.m., shotgun start at 12:30 and dinner and prizes at 6:00 p.m. Registration forms are available online at: www.acfo-acaf.com/golf/registration-e.html or you can register by calling Danielle Graham at the Association, 613-728-0695 ext. 224. * The Association represents more than 3,600 financial officers in the federal public service, with approximately 60% of its members being in the National Capital region.
This past year has been my first full year as your Treasurer - and it has been an interesting one. From a financial point of view, the biggest change was the implementation of the legal Agreement between the University of Ottawa Heart Institute (UOHI), the Ottawa Heart Institute Foundation (OHIF), and the Ottawa Heart Institute Alumni (OHIA). This Agreement establishes the OHIF as the sole fund-raising face for the Ottawa Heart Institute although provision was made in the Agreement for Alumni members to dedicate their contributions to the OHIA if they so wished. Given the above, I can report that the OHIA financial recording and reporting are accurate and that the monies spent in this past year have been spent prudently; are in line with the wishes of the OHIA members; and are expended in accordance with the objectives as set out in the OHIA By-laws. In addition, I can report that the OHIA is financially sound and that its reserves provide the necessary wherewithal to continue operations for the foreseeable future. Finally, I would, once again, like to take this opportunity to thank ALL OHIA members for your past and continuing contributions. Your support for the Ottawa Heart Institute and its patient care and comfort is greatly appreciated. The OHIA is there solely to serve your needs and, through you, to help others who might be in a similar situation going forward. Thank you. E. J. (Ted) Legg
 
by Dr. Thierry G. Mesana, M.D., PhD, FECTS, FRCS(C)  Dr. Mesana The Alumni-organized Fall Lecture featured Dr. Mesana, Chief of Cardiac Surgery at the UOHI. Dr. Mesana is a native of France who was hand picked for the Institute by Dr. Keon who considered him to be the most amazing talent with the greatest skills to succeed him. A full house of attendees enthusiastically listened to his expert review of the state of cardiac surgery. Dr. Mesana commenced by stating that cardiac surgery started about 50 years ago to help babies with congenital heart problems and young patients requiring valve surgery. The services very quickly expanded to embrace other types of heart disease, e.g. coronary bypass surgery, as the art of grafting was perfected.  Providing such services to seniors came quite a bit later with the improvement of technology and the confirmation that cardiac surgery could be performed successfully on the elderly. In the 1980s, coronary heart surgery shifted to interventional cardiology conducted in cath labs. Angioplasty is one example, using a "balloon" to undo arterial blockages without opening the chest. Instead, a catheter is introduced through the artery to perform the procedure. In the 1990s the coronary stent was invented to strengthen the arteries to prevent re-stenosis. Once again, a catheter is used for its implant. These days, there is even a drug to prevent re-stenosis in the stents. Valve surgery has been increasing in numbers given our ageing population. Although successful, the ever-evolving procedures of cardiac surgery coupled with extensive research have resulted in the development of percutaneous (non-surgical) valve procedures. By-pass surgery has also been advancing since its emergence in the 1970s. Now instead of veins, the surgeon may use internal mammary arteries (IMAs) are found around the sternum that are superior conduits to veins. IMAs have been found to stay open longer, and provide a better blood flow. Current experience indicates that IMAs could last 10-15 years or longer, whereas veins could last only about 10 years. In the 1960s the first arterial grafting surgeries were performed without using the heart-lung machine. Because of the movement of the heart, it required great dexterity to make an incision in the vessel that is only 3-4 mm and subsequently to suture it to minimize bleeding. Subsequently, greater use was made of the heart-lung machine. However, the disadvantage of this equipment is that it creates an unnatural physiological blood circulation, which can cause damage to the brain, heart and lung. Presently, there are devices and supporting technology to immobilize the specific area of the heart where the bypass will take place. Artificial valves have also undergone considerable change over time. Evolution of valves from porcelain to piglet valves mounted on a stent (used mostly for older patients) lasts 12-15 years. Interestingly, the longer it lasts, the less likely that it will wear out. There is also a trend to use piglet valves without the stent. It appears that stent deterioration is a greater problem than that of the piglet valve. Finally, a relatively limited number of transplants of human valves are performed when a donor is available. Dr. Mesana has specific expertise in repairing the heart valve instead of replacing it. Such repairs call for a very delicate operation. Hence it is relatively rare due to the shortage in experienced surgeons. Nevertheless, the success rate is high with a skilled surgeon. There are close to 135 repairs performed a year at the UOHI and the numbers are growing dramatically. What does the future hold? We can look forward to further development of percutaneous valves, stented aortic valves that can be introduced in the heart through the groin with the aid of a catheter. At the present time, this is a relatively new technology with the risk of death rather high at 40%. The cost of the procedure is expensive, being in excess of $25,000. Some surgeons are wondering if cardiac surgery will disappear in 20 years due to the growing use of less intrusive methods. Dr. Mesana emphasized that surgeons will continue to be needed. He feels strongly that the new generation of surgeons will continue to be progressive with the development and application of new technologies and skills. They will be open and adaptable to new technologies. Therefore, more cardiac surgeons should be trained, but differently than 25 years ago. Recent medical statistics show the number of open-heart surgeries is still growing and in particular the new less invasive interventions are escalating. In fact in 2006, it was already reported that there would be a shortage of heart and lung surgeons due to retirement as 73% of the current ones will be retired by 2019. The shortage, coupled with the increased demand produced by aging baby boomers, assures aspiring surgeons of a solid career. The challenge will be to attract the best minds and abilities, given that the typical health plans do not adequately compensate cardiac surgeons by comparison to several other types of surgeons. At the UOHI, 4 residents are being trained currently for cardiac surgery. The UOHI Cardiac Surgery Division has enjoyed well-deserved prominence for its achievements and has received many awards. With great pride for the quality and accomplishments of his team, Dr. Mesana is modest as he claims that his only legacy will be in the heart of his patients. They have maintained contact with him over the years and continue to express their thanks and admiration to this Doctor with skilled hands, a warm heart, and a glowing reputation.
June 3, 2008 at 6:30 PM
NEPEAN SPORTSPLEX, RICHMOND ROOM 1701 Woodroffe Avenue Nepean, Ontario For many years, the Annual General Meeting was held at Capone's East on Industrial Avenue, but this restaurant closed at the end of June 2007. Therefore, the 2008 AGM will be held in the Richmond Room at the Nepean Sportsplex, which is located just south of Hunt Club Road on Woodroffe Avenue. There is ample parking behind the Sportsplex (on the east side), where the entrance to the Richmond Room is located. Go in Entrance C. There is a fairly short stairway up to the Richmond Room. If the stairs pose a problem, inside the entrance there is a door on the right that leads to an elevator to the Richmond Room level. Catering is by Capone's. NOTICE IS HEREBY GIVEN THAT: Pursuant to Section III, Articles 30 - 37, inclusive, of the Constitution of the Ottawa Heart Institute Alumni Inc., the Twenty-second Annual General Meeting of the Alumni will be held on June 3, 2008 in the Richmond Room of the Nepean Sportsplex, 1701 Woodroffe Avenue, Nepean, Ontario at 6:30 PM. AGENDA:
* More information on items 6 and 7 on our website www.ottawaheartalumni.ca and at the AGM. POST MEETING PROGRAM
Seating will be limited. Please complete the form below and mail to:  (print this form)
Presented by:
 Dr. Robert Reid, MBA, PhD Associate Director Minto Prevention and Rehabilitation Centre University of Ottawa Heart Institute On: Tuesday, April 24, 2008 Please call 613-761-4370 to indicate your wish to attend this popular lecture. Seating is limited. Spouses welcome.
The Bulletin is published in Ottawa by the Ottawa Heart Institute Alumni Inc., a not-for-profit corporation located at 40 Ruskin Street. It is distributed free to members of the Ottawa Heart Institute Alumni and contains information on health and other matters of interest to members. Contents do not necessarily reflect the opinion of the Board of Directors, nor does the Ottawa Heart Institute Alumni Inc., nor the producers, nor the printers and distributors of the publication assume any responsibility for opinions expressed. All communications and contributions should be sent to the address below. PUBLICATIONS MAIL AGREEMENT NO. 40045889 RETURN UNDELIVERABLE CANADIAN ADDRESSES TO: The Bulletin Editor Editor: John P. Herzog Contents are copyrighted and may not be reproduced without permission. The Bulletin is intended for general information only and is not a substitute for medical advice or treatment for specific conditions. You should seek medical advice for any specific health issues and consult your physician before starting a new fitness regime.
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It is with great pleasure that I write this report to you, our members, some 8,000 strong. Indeed, most of us are stronger due to the excellent care we have received at the University of Ottawa Heart Institute.
If you are interested or would like more information you can contact Dana at (613) 798-5555 (ext. 17340) or send her an e-mail 
This charity golf event was first held in 1996, in memory of Rick McCallum, Vice President of the Association. Many of us who have worked in the Public Service knew Rick, who worked for Transport Canada. Rick died from heart disease in 1995. Since then, ACFO has raised over $110,000 for the Heart Institute and the Alumni.