LECTURES

Ottawa Heart Institute Alumni Spring Lecture
April 22, 2002

"Cardiac Surgery, from France to Canada: Is There a Difference?"
Dr. Thierry Mesana, Chief of Cardiac Surgery

Dr. Mesana thanked the Alumni Association for the opportunity to come and speak and for the very strong support that the Alumni had given to the Institute for many years. He was honored to be asked.

He was already a Chief of Cardiac Surgery in France, having progressed through all of the many long and difficult steps in the medical profession to reach that level. Thus to consider leaving was a very difficult decision. He had succeeded a renowned cardiac surgeon, who had stepped aside so that Dr. Mesana could take his place, but that distinguished gentleman encouraged him to take up the new challenge in Canada.

Being a Chief Surgeon means being a leader, providing inspiration, marshalling all of the resources needed to achieve new goals. He had a great team in Marseilles, but at the Institute he has found a great sense of family, with excellent, dedicated and enthusiastic staff. Shortly after his arrival, the nurses presented him with a carrot cake for his birthday. After but a few days, he felt as though he had been here for years.

His father wanted him to take up a different profession, but his sister was already a medical doctor and she pushed him in that direction. During his medical residency, he concluded that the heart was the most interesting of the organs, pumping 75 gallons of blood a day along a circulatory system 12,400 miles long, with its own nervous system.

One of the differences he has noted in Canada is the size of the patients. Recently he operated on a patient who weighed 400 pounds. He was so large that Dr. Mesana had to stand on a bench to gain proper access to the patient on the operating table. More Canadians die from heart disease than cancer and AIDS combined. We eat too much and don't get enough exercise.

But in spite of this unhealthy lifestyle, we are living longer because of improvements in cardio-vascular techniques. Dr. Mesana spoke of the courageous pioneers who paved the way for the dramatic innovations that have occurred during his career.

He spoke again of his responsibilities to provide leadership to the team of doctors, nurses and patients to achieve success. In particular, an academic institution must do three things. It must teach, perform, and innovate. Heart transplants are so numerous there is a shortage of hearts. The extensive use of stents has gone from almost zero to ½ million in four years. The use of angioplasty is exploding. The challenge to cardiac surgeons is to encourage more innovative cooperation between surgeons and cardiologists. In the near future, there will be more micro-surgery and encouraging the heart to regenerate itself. Then there will be robotic surgery and the challenge of information technology.

The challenge will be to innovate and reduce costs. Doctors must form alliances with other health care professionals always being conscious of what is best for the patient.

Dr. Mesana concluded by reminding the audience that "We are angels with one wing. We can only fly while embracing one another".

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