Montreal Heart Institute”s technology a “gamechanger” for complex heart defects


After years as a Montreal Heart Institute patient, Keeron Tom didn’t think twice when his doctor proposed a cutting-edge intervention to fix his broken heart.

“Not being dead is a great way of being persuaded,” joked Tom, 41, a sound engineer, at Wednesday’s ribbon-cutting inauguration of the institute’s $6.8-million electrophysiology laboratory equipped with robotic and magnetic navigation.

The electrophysiology operating room is considered Canada’s first such lab dedicated to congenital heart diseases. Sunnybrook Hospital in Toronto has a similar system, but not for congenital heart defects.

In June, Tom had a close call with death while playing volleyball. The next month, he became the lab’s first patient.

No stranger to hospitals, Tom was a “blue baby,” born with a rare but serious heart defect where the great arteries are transposed. Within hours of birth, he needed surgery to reconnect the aorta and the pulmonary arteries to their proper ventricles. Then, at almost two years old, he collapsed in a hospital hallway because his heart stopped pumping.

In his 30s, he got a pacemaker, followed by a defibrillator implanted to prompt his heart to work regularly. Suddenly, during the June volleyball game, he had to sit down to catch his breath. His heart raced — beating 230 times per minute — according to data collected by the defibrillator. 

“You’re feeling severe anxiety, the adrenalin is pumping, it’s nerve-racking,” Tom explained.

At the institute’s emergency room, staff shocked his heart back to normal cardiac rhythm, but because of the scarring on his heart, Tom knew it would only be a matter of time until the next near-death incident. 

His first impression of the institute’s high-tech operating room, he said, was “very James Bond.” 

 Tom’s operation lasted almost 11 hours. He lay on a table between two giant magnets. Doctors connected a catheter with magnets built into the tip to a robotic arm, inserted the tip into an artery in the groin area and stepped out of the room.

“We do the entire intervention in front of monitors in the control room,” explained cardiologist Paul Khairy, director of the institute’s Adult Congenital Centre. He also holds a Canada Research Chair in electrophysiology and adult congenital heart disease.

Handled with a mouse, a joy stick and floor pedals, Khairy manipulated the catheter with the magnetic field. He could locate the scarred part of Tom’s heart, “hidden behind scarring and baffles and conduits,” thanks to the cutting-edge technology of a supple catheter that can make right turns and circles. Led to the right spot, it burns away the scar tissue.

“With this, there’s no danger of poking a hole in the patient’s heart,” Khairy said.

About 15 to 20 per cent of patients with congenital heart defects could not be helped with a regular catheter because of the obstructions in their heart muscle, he explained.

“This is a game-changer for those patients. It allows us to treat patients that otherwise we could not treat,” he said. “We did the best we could, but they would come back on regular basis, some weekly, to emergency and we’d have to shock them out of it, and there were not a whole lot of options for them.”

The Montreal Heart Institute is a centre of excellence for the treatment of arrhythmias — a leading cause of death — and handles patients from across Quebec, Canada and a few from Europe.

About one per cent of the population is born with a congenital heart defect, which is the leading cause of infant mortality, Khairy said. But four or five decades ago, 85 per cent of these patients died in childhood. Now, with improvements in surgical and medical care, more than 90 per cent, even with the most complex defects, are now surviving, he said.

“And they’re thriving well into their adult years. We even have geriatric patients,” Khairy said. “So we created a specialty in cardiology to take care of those patients and we’re learning from them, what type of complications they encounter and how we can prevent these and how we can best treat them.

“It’s heartwarming to see patients we’ve been treating for years who were considered not candidates for these procedures … to see them doing well.”

The institute is expecting to operate on its 32nd patient in its new facility on Thursday.

As for Tom, his operation was over at about 6 p.m. He was up and walking by midnight, home within two days and back at work the following week. He’d like to thank the institute, particularly Dr. Khairy, for saving his life again and again.