Institute a cardiac surgery powerhouse in Canada

The Libin Institute has established itself as a cardiac surgery centre of excellence nationally and internationally. Performing 1,800 operations annually, the Division of Cardiac Surgery is not only a leader in minimally invasive and complex aortic procedures, but it also boasts the largest surgical residency program in Canada. Researchers within the division continue to put Calgary on the map with their discoveries, enhancements and collaborations that all lead to better patient outcomes. 

Residency program: training the next generation

Calgary’s cardiac surgery residency training program was introduced in 2006 by Dr. John Burgess. The six-year program is renowned for exposing trainees to procedures in general cardiac surgery, along with subspecialized areas. Trainees also receive academic training, an option that has resulted in a several residents achieving a PhD during their residency program, allowing them to pursue careers as clinician-scientists. 

According to Dr. William Kidd, the section chief of Cardiac Surgery, although Calgary’s program is newer than many in Canada, it attracts the top students and surgeons from around the country.

“I attribute this to the way that the surgeons and other members of the team interact with the residents, and how the residents support one another,” he says. “We don’t have transplants or pediatrics, but we have a culture that people want to train in.”

Dr. Ali Fatehi Hassanabad, a surgical resident and PhD student within the Cardiovascular and Respiratory Sciences and Clinical Investigator Program, received a prestigious Vanier scholarship in 2020. 

When asked about his achievement, he credited the Institute’s surgical program for his success. 

“The cardiac surgery training program is a phenomenal program that offers everything a trainee can expect,” says Fatehi Hassanabad. “The staff mentor me, and I am very appreciative of that. Without that support system, I would not have received this scholarship.”

Hybrid cardiac operating room – paving the way for advancements

Southern Alberta's first cardiac hybrid operating room (OR) opened in 2014 at Foothills Medical Centre and combined traditional surgery with advanced, less invasive techniques. The hybrid OR was backed by philanthropy, including the Calgary Health Foundation, which raised $5.1 million for the facility. 

Upon opening, the hybrid OR was equipped with highly specialized equipment and infrastructure that supported state-of-the-art cardiac interventions and surgical care for patients. 

According to Kidd, the hybrid OR continues to be a game changer for Calgary’s cardiac surgery program. 

“Building the hybrid cardiac OR was very forward thinking, and we would be a decade behind in what we are doing without it,” says Kidd. “It’s critical in what we are doing today and wouldn’t have been possible without the generous support of the community.” 

Today, the OR facilitates partnerships between cardiac surgery and cardiac intervention, allowing complex procedures like thoracic endovascular aortic repairs, transcatheter aortic valve implantation, and new devices such as the Neochord, which allows surgeons to operate on patients without the need for a heart-lung bypass machine, and mitral clip, which allows for mitral valve repairs without the need for an incision. 

Minimally Invasive Cardiac Surgery: Getting patients back to their regular life sooner

The hybrid OR laid the foundation for Calgary’s Minimally Invasive Cardiac Surgery (MICS) program. Historically, valve repairs and replacements were done through open heart surgery, but the specially trained minimally invasive cardiac surgery team can repair and replace valves and perform a unique bypass surgery called MIDCAB, through a small incision in the side of the chest.  These techniques help get patients home faster and back to their regular lives sooner. 

Dr. Andrew Maitland introduced minimally invasive techniques to Calgary when he performed the first minimally invasive cardiac surgery – a valve repair – in 2012. Since then, the team has expanded in size in scope. Under the leadership of Dr. William Kent and Dr. Corey Adams, the team performs about 400 surgeries per year. 

The group has also introduced a training component, bringing in teams from around Canada and visiting sites as far away as Poland to teach these advanced surgical skills. The team hosts and organizes an annual Western Canadian Minimally Invasive Surgery Conference. 

According to Dr. William Kidd, the section chief of Cardiac Surgery, Calgary is amongst the top three in the country for minimally invasive surgery, with about 400 Procedures being done annually. 

Calgary Aortic Program: Better together

In 2019, Calgary’s Aortic Program was established with the goal of bringing cardiac surgeons, cardiologists, interventional radiologists and vascular surgeons together from across the city to optimize care for patients with complex aortic disease, ranging from aortic dissections to thoracoabdominal aneurysms.  Dr. Scott McClure, Dr. Randy Moore, Dr. Eric Herget, and Dr. Michelle Keir lead this multidisciplinary team, pooling their expertise both inside and outside the operating room. 

CAP’s formalized structure is quite unique, says McClure, noting the Calgary Complex Aortic Clinic, which physically brings together experts from across the specialities and acts as a hub for innovative treatments, is the first of its kind in Calgary. 

“The clinic benefits patients in a number of ways,” says McClure, noting it’s a one-stop-shop for patients that brings together experts, ensuring they receive the best possible treatment for their individual condition. 

Bringing together experts in a formal way has gotten CAP noticed. The team has become a pilot centre in Canada for several surgical repair devices, brining the latest technology to Calgary. 

Moving forward, the CAP team has created a fellowship designed to train aortic specialists that integrate knowledge from several disciplines to ensure the best possible outcomes for patients. 

“I am proud that we have overcome the logistical challenges and created an aortic model,” says McClure. “We are convinced that this model is best for patient care.” 

Working together for a better future

As the surgical care teams continue to improve, Kidd is optimistic about the future of cardiac surgery in Calgary. 

“I am excited about the collaborations,” he says. “Many advanced surgeries have to be team and disease based and our growth in these areas is exciting.” 

Read more about the Libin Cardiovascular Institute's Top 20 Achievements of the last 20 years here.