Wait time for cardiac surgeries soars

With eight months to go until a long-awaited expansion is complete, cardiac surgery wait times at the University of Ottawa Heart Institute are the longest in Ontario — more than triple the provincial average in the case of elective bypass surgery.

A patient undergoing elective bypass surgery at the Heart Institute waits an average of 95.7 days, according to recent figures from Health Quality Ontario, compared to an average wait of 27.4 days province-wide and significantly lower at some hospitals.

The province measures several cardiac procedures and patients at various levels of urgency to monitor wait times.

In general, it is elective patients — the least urgent ones — who are waiting, sometimes bumped by growing numbers of urgent surgeries.

CEO and president Dr. Thierry Mesana acknowledged that the heart institute has the “longest wait list in Ontario,” something that causes him concern.

“My concern as a CEO is how safe is it to have so many patients waiting for surgery — that is what keeps me awake at night.”

The hospital has taken steps to closely monitor patients on waiting lists with frequent phone calls to keep track of any changes in health that might require surgery sooner.

It has also created a Cardiac Pre-Hab program to help get patients as fit and ready for surgery as possible while they wait.

The heart institute has also reduced the numbers of elective patients it takes from the Outaouais, which means they must travel to Montreal, although Mesana said it will not place limits on more urgent Quebec cardiac patients.

“We have an ethical responsibility toward people from Quebec. If there is somebody in the hospital in critical condition, how can you imagine we not do surgery on this person?”

Several years ago, the heart institute added surgery on weekends to reduce wait times — which went up again when volumes increased.

More recently, it considered adding surgical hours in the evening, but rejected the idea, said Mesana. “You cannot have people working doing elective cases at night.”

Despite its struggles with long wait times, the heart institute — as recently as last year — received the highest patient satisfaction rating in the province, according to one survey. And when offered a chance to go to another hospital rather than stay on the waiting list in Ottawa, Mesana said, patients generally say no.

The heart institute has seen a nearly 20-per-cent increase in cases in the past nine years, which means emergency surgeries more frequently bump elective surgeries.

Not only are there more patients in need of cardiac surgery, but the nature of cardiac surgery is changing, he said. At one time, 90 per cent of the surgeries were bypasses. Now half of patients require other kinds of cardiac surgeries, including valve replacements.

The hospital’s focus now is on the opening of a new $220-million tower that will house five — with room for a sixth — state-of-the-art operating rooms, labs, intensive care and patient rooms.

Mesana said the expansion will increase the heart institute’s capacity by 150 cases next year and

an additional 100 cases the following year. The heart institute currently performs about 1,600 open-heart surgeries a year.

“For us it is absolutely critical to open this new tower in April. This is the only good answer.”

While wait lists will not disappear entirely with the expansion, he said they will be more manageable.

Meanwhile, surgeons at the hospital performed three heart transplants on a recent weekend, bringing in surgical teams on call. Mesana said he admires the team for improving productivity and saving lives, despite infrastructure limitations.

“There are 1,500 people in this building who really give their lives to the patients.”

He said the long wait lists underscore the need for the expansion.

“We would have liked it to (open) two or three years ago, but imagine where we would be today if we didn’t have the expansion.”