Cardiac Care Program

The cardiac surgeons, cardiologists and program staff of LHSC’s Cardiac Care Program provide care for more than 130,000 patients each year from across southwestern Ontario and beyond. The Cardiac Care Program takes an interdisciplinary approach to patient care, combining surgery and medicine within one program.

Inpatient cardiac care is provided in 98 beds at Victoria and University Hospitals. In 2009 – 2010, more than 1,300 heart surgeries were performed including those using minimally invasive and robotic techniques.

Nearly 3,900 cardiac catheterizations were performed last year, as well as 1,500 interventional procedures and 900 pacemaker and intracardiac defibrillator implantations.

A range of diagnostic testing is offered including echocardiograms, exercise stress tests, holter monitoring and electrocardiograms.

Cardiac rehabilitation and secondary prevention programming provides education and rehabilitation to cardiac patients and those at high risk for cardiac events.

Over the years, the Cardiac Care Program has celebrated 19 medical and surgical firsts in Canada, North America and the world.

ABOVE: The Primary PCI Program at LHSC ensures that patients experiencing a heart attack are brought directly to the University Hospital Emergency Department to undergo immediate angioplasty. This program required planning and co-operation across a number of areas including the emergency department, cardiac care, division of cardiology, Base Hospital program, and emergency medical services.

innovative care

The first 90 minutes following a heart attack can be the difference between life and death. If a patient experiencing a heart attack has blood flow restored to the heart muscle within that time, they have fewer complications, less long-term damage, a shorter hospital stay and better chance for a full recovery.

Marlene Allegretti is a nurse practitioner in the Coronary Care Unit (CCU) at London Health Sciences Centre’s (LHSC) University Hospital (UH) and over the past five years has helped develop and implement an innovative program to treat patients having a heart attack within those critical 90 minutes following the onset of symptoms.

Known as the Primary PCI Program, this life-saving process ensures that all heart attack patients are brought directly to UH where a team performs an immediate angioplasty (also known as percutaneous intervention or 'PCI'), a procedure that threads a catheter through an artery in the patient’s leg to blow up a tiny balloon that opens a blocked vessel supplying blood to the heart muscle.

"I was impressed with the speed and efficiency staff displayed to get me to the cath lab. Every staff member I encountered took the time to explain everything that was happening, even during my angioplasty. I truly believe these people saved my life."

~ Paul Voogt, Primary PCI patient

"The Primary PCI Program is now one of the best treatments for most heart attack patients," says Allegretti, who adds that before they started the program at UH it was only being done similarly at two other centres in Canada.

The Primary PCI Program has grown slowly over the years, initially running during regular business hours, Monday through Friday. Since September 2009, the program runs 24 hours a day, seven days a week and treats approximately 150 to 200 patients per year.

It was a collaborative effort to implement and expand the program, with more than 20 individuals working together from across a range of health care disciplines including: emergency, medicine, cardiology, ambulance, emergency dispatch and the Southwest Ontario Regional Base Hospital Program.

A system is now in place where paramedics, who have been trained to perform an electrocardiogram (ECG) on the patient, can electronically send ECG results directly to the waiting cardiologist. He or she then arranges for the patient to go directly to the catheterization lab to have the blocked vessel opened by angioplasty.

Five years ago, Allegretti became the first nurse practitioner in the CCU. She completes daily rounds with physicians, assisting with admissions, discharges, as well as the day-to-day tasks in the 13-bed unit that treats the most critical of cardiac patients.

"The nurse practitioner role allows for more comprehensive patient care; a more holistic approach to treatment," says Allegretti, who has been a nurse at LHSC for 33 years.

Looking ahead to the prospect of expanding the Primary PCI Program to regions within 60 minutes travel time to UH, Allegretti is busier than ever, helping to develop protocols for the paramedics to ensure that once an ECG confirms the patient is experiencing a heart attack, no matter what hospital is closest the patient is brought directly to University Hospital for an immediate angioplasty.

Despite the busy days she spends caring and innovating for LHSC's patients, Allegretti says it's a simple reason that keeps her coming back, one that's inherent in her own DNA.

"I love what I do," she says with a smile. "I got into nursing because I like to help people. That hasn't changed in more than 30 years."