Cardiac Surgery

Cardiac surgery at the University of Ottawa Heart Institute is dedicated to life-saving procedures and to advancing surgical techniques and treatment methods. Our surgeons specialize in reconstructing damaged portions of the heart and solving complex problems, often using minimally invasive procedures. Our surgeons have pioneered novel methods that are now used around the world, including minimally invasive multivessel coronary bypass surgery and key aspects of aortic valve repair.  

We have one of the most successful and innovative heart surgery programs in Canada. We are a recognized leader in less invasive bypass and valve surgery, repair of mitral, aortic and tricuspid heart valves, the quality of surgical outcomes, and patient satisfaction. Our heart transplant program has performed more than 600 transplants and serves patients from across the country. We pioneered innovative surgical methods, such as minimally invasive coronary artery bypass, and educated surgeons here and abroad in these new techniques. 

We perform more than 1,900 open-heart procedures annually and conduct research into progressive clinical practices and scientific approaches to ensure the best possible outcomes for our patients. Cardiac surgery has a proud, founding legacy at the Heart Institute. Our physicians continue to set the standard in care, education, and research, nationally and internationally.

Programs & Units 

The Heart Institute is an international leader in cardiac surgery. We have among the lowest mortality rates and largest patient volumes throughout North America, particularly for high-risk patients. Our Cardiac Surgery program provides a model of surgical performance and expertise in which patient diagnosis, assessment, treatment, and follow-up involve a concerted team approach.

Clinical Specialties

Minimally Invasive Coronary Artery Bypass

Through a small incision between the ribs, multiple healthy blood vessels are grafted onto arteries to bypass coronary blockages. Surgeons operate while the heart is beating, and they can address all vessels around the heart. The standard open-heart method involves stopping the heart, using a heart-lung machine, and incising the breastbone to open the chest. Only a few sites in North America perform this alternative procedure, particularly when multiple bypasses are needed, which requires specialized tools and training and was largely developed in Ottawa. We offer the procedure to be performed either in the “conventional” way or by using our newly acquired robot, donated in large part by the family of a grateful former patient.

Valve Repair

We specialize in heart valve surgical techniques—for reconstruction of valves instead of replacement—including mitral and less commonly performed aortic valve repair. Our surgeons also perform aortic valve procedures by using minimally invasive surgical techniques. The comprehensive Valve Surgery Clinic follows patients after surgery to ensure thorough follow-up care over time.

Trans-catheter aortic valve implantation (TAVI)

For patients suffering from aortic stenosis (narrowing of the aortic valve) who are not good candidates for surgery, TAVI offers a minimally invasive option. Our medical team combines the exceptional skills of a surgeon and an interventional cardiologist in performing this catheter-based procedure. Well over a decade ago, our team at the UOHI was pioneeringly involved in the 100 first published cases worldwide of this now well-diffused procedure.

Heart Transplant

The Heart Institute’s first transplant was performed in 1984. Today we conduct as many as 36 transplants here annually. Transplant patients are seen in the Heart Function Clinic when their hearts are no longer strong enough to pump adequate volumes of blood. The Heart Institute helps set the standard for transplant procedures and protocols across the country as a leading member of the Canadian Cardiac Transplant Group. In 2012, the Institute performed its 500th heart transplant, and we have since surpassed the benchmark of 600 such procedures.

Ventricular Assist Devices

Left ventricular assist devices (LVAD) temporarily replace the heart’s pumping action and are surgically implanted for patients with end-stage heart failure who are waiting for a heart transplant (known as “bridge to transplantation”). The device takes blood from the left side of the heart and pumps it back to the aorta, the major vessel in the body. An LVAD is used until a donor heart is available for transplantation or in patients who are expected to improve (known as “bridge to recovery”).

Thoracoscopic Surgical Abnormal Heart Rhythm Ablation

In this procedure, surgeons manoeuvre miniature tools through a keyhole-sized incision to destroy, or ablate, a targeted area of the heart. The ablation effectively short-circuits troublesome nerve endings responsible for atrial fibrillation, the most common form of arrhythmia.

Pulmonary Thromboendarterectomy

In some patients, blood clots that travel to their lungs do not dissolve as they should and block the flow of blood. Blood pressure remains high, causing a persistent strain on the right side of the heart. The result is a condition known as chronic pulmonary embolism or chronic pulmonary hypertension. The Heart Institute is a designated Canadian centre for pulmonary thromboendarterectomy (PTE), a complex surgical procedure in which blood clots that block pulmonary arteries are removed.

Thoracic Aortic Repair

Like an inflated balloon, the wall of the aorta becomes thin and can tear (dissect) or rupture when it is stretched by an aneurysm. Aortic dissection or rupture requires immediate surgical repair. Patients with aortic disease are managed in the Aortic Clinic.

Research 

Surgeons and scientists at the Heart Institute combine their experience and skill to improve patient quality of life, ensure better outcomes, and maintain a progressive approach to cardiovascular medicine. From its inception, the Heart Institute has pioneered novel surgical procedures that give patients a chance to lead better lives. Internationally, we currently stand among the most productive divisions in the cardiac surgery landscape. We are involved in nearly 80 scientific publications per year, and regularly provide numerous expert lectures internationally. We lead many international clinical trials in coronary, minimally invasive, valve, and aortic surgery.  

For more information, see below.

Research Clusters

Research Teams​

Education 

Our diverse skills, collaborative setting, and innovative procedures provide an excellent environment for training young physicians and researchers. Our educational activities address students at all levels.

Undergraduate

Up to 15 medical students rotate annually through our cardiac surgery program, including elective students from the faculties of medicine in other provinces.

Residency

Cardiac surgery as accredited by the Royal College of Physicians and Surgeons of Canada for medical residents requires at least six years, following the completion of medical school.

Fellowship

The University of Ottawa offers clinical fellows one of the most advanced and diverse surgical training sites in Canada. To apply, both Canadian and International Medical Graduates must complete the Cardiac Surgery Fellowship Application form (PDF) and submit documentation via the University's Faculty of Medicine, Postgraduate Medical Education website.

Important dates and deadlines

  • Applications for 2021 are now closed.
  • Applications for 2022 will open on May 1, 2020.

Canadian Medical Graduates (CMG):

Applications can be sent directly to the clinical fellowship director including the program administrator, Isabel Menard, in the response. The following documents must be included:

  • Personal statement;
  • Curriculum Vitae;
  • Three (3) letters of recommendation;
  • Completed Cardiac Surgery Fellowship Application form and documentation to the university.

International Medical Graduates  (IMG):

Applications must be submitted through the Fellowship Application System for International Medical Graduates.

Applications must be submitted through the University of Ottawa.

After applications have been successfully submitted via the online application system, please email the completed Cardiac Surgery Fellowship Application form to the clinical fellowship director including the program administrator, Isabel Menard, in the response.

Dr. Juan Grau, MD FACS FACC
Clinical Fellowship Director
Division of Cardiac Surgery
University of Ottawa Heart Institute
40 Ruskin Street
Ottawa, ON K1Y 4W7
Email: jgrau@ottawaheart.ca

Isabel Menard
Postgraduate Program Administrator
Division of Cardiac Surgery
The Ottawa Hospital, Civic Campus
Loeb Research Building, Main Floor
725 Parkdale Avenue
Ottawa, ON K1Y 4E9
Email: imenard@toh.ca

More information regarding University of Ottawa fellowship programs can be found on the Faculty of Medicine, Postgraduate Medical Education website.

Graduate Education

Training at the Heart Institute incorporates laboratory research in which young scientists investigate the means of rebuilding tissue in and around the heart. Master’s and PhD candidates in cellular and molecular medicine are supervised in groundbreaking basic research.

For more information, please see Cardiac Surgery Education.

Postgraduate Peer-to-Peer Education

Our team has taught advanced surgical techniques at live symposia and in peer-to-peer fashion not only in Ottawa, but also at many other institutions around the world. Our surgeons have performed live surgeries watched by countless surgeons and team members, in Canada and in several countries abroad. Our division has also been entrusted with several international visiting awards given to established surgeons, to come spend several months at the UOHI and further their education and scope of practice.

Over the last decade, we have trained, through peer-to-peer observerships, well over 100 established, visiting heart surgeons and their teams, from institutions that include Stanford University, Columbia University, Harvard University, the University of Toronto, Leipzig German Heart Centre, Tohoku University, Georgetown University, Baylor University, Université Laval, McMaster University, and numerous others. Surgeons have come to learn MICS CABG, MICS valve, or advanced aortic valve procedures. Our peer-to-peer philosophy and collaborative programs have been an important component of furthering the diffusion of the surgical techniques that are performed and often were developed by our Cardiac Surgery Division, at the UOHI.

Team 

Marc Ruel, MD, MPH, FRCSC, FAHA, FCCS
Division Head, Cardiac Surgery

Surgeons

Surgical Assistants

Scientists

Research Coordinators

  • Jacqueline Fortier, MSc
  • Suzanne Crowe

Executive Assistant

Beth Wallace
613-696-7288

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