Meet the Heart Institute’s Incoming President and CEO

October 8, 2013

A renowned cardiac surgeon, a champion of innovation, and an experienced and respected administrator, Dr. Thierry Mesana is also a passionate advocate for the University of Ottawa Heart Institute. On September 11, the Heart Institute announced his appointment as its third President and CEO, to succeed Dr. Robert Roberts in 2014.

A native of France, Dr. Mesana is recognized as one of the leading heart valve surgeons in the world. In the early 1990s, he was the youngest cardiac surgeon in France to receive full professorship. He then became the Chair of Thoracic and Cardiovascular Surgery at La Timone University Hospital, the largest hospital in Marseilles, where he introduced a number of advanced techniques and greatly expanded the cardiac surgery program.

Strongly committed to research and innovation, Dr. Mesana holds a PhD in biophysics and biomechanics in addition to his MD. He conducted important early work developing novel concepts for ventricular assist devices and artificial hearts, pioneering electrically driven rotary pump technology. Similar technology is now the clinical standard for saving patients with end-stage heart failure. He was also a leader in the clinical use of implantable artificial hearts in Europe. These innovations led to his increasing prominence and a visiting professorship at Harvard Medical School, where he conducted leading research in cardiomyoplasty, the use of electrically powered skeletal muscle to reinforce failing hearts.

Dr. Mesana joined the Heart Institute as Chief of Cardiac Surgery in 2001, a position he held until stepping down earlier this year. Under his leadership, the Heart Institute’s valve repair program has become recognized as one of the best in the world. His emphasis on repairing failing heart valves helped establish this approach as a gold standard for treatment. In addition, he has encouraged the development of minimally invasive surgical procedures for coronary bypass grafting and complex cardiac arrhythmias. Just as important, Dr. Mesana has been instrumental in fostering collaboration across scientific and clinical boundaries, always with the goal of enhancing patient care.

He will begin to assume many responsibilities in January, with Dr. Roberts fully handing over leadership in April 2014. Dr. Mesana will continue to offer his clinical expertise to patients on a limited basis.

The Beat: Why did you want to be the next President of the Heart Institute?

Dr. Mesana: In my time here, the Heart Institute has been very good to me, allowing me to achieve many of my dreams as a surgeon, and I will always be grateful for that. I wanted to be its next leader in order to give something back, to serve the family of the Heart Institute, to serve the staff and the patients. I was able to do that to a certain extent as Chief of Surgery, but now I will be able to have a greater impact.

I came here 12 years ago because I really believed in the concept of the Heart Institute and I am convinced more than ever that we have a unique setting here in Ottawa. We have, integrated in one building, all the professionals in cardiovascular health care and science working together for the same end. It’s not that way at other centres, not to this extent. Cardiologists and surgeons, all these professionals, talk to each other and work together on a daily basis. That’s what makes the Heart Institute so special. The role of the CEO is to maintain and reinforce this, to continue gathering these people together and make sure no one works in isolation.

Moreover, I want to transmit to the younger staff members the family spirit of the Heart Institute and the shared sense of purpose. It’s important that people who come to work here have that same spirit, that esprit de corps.

I’m going to paraphrase JFK here and will say to new recruits: Don’t ask yourself what the Heart Institute can do for you—ask yourself what you can do for the Heart Institute. It’s that spirit, that legacy that will let the Institute endure and get even stronger.

I am very proud to have been chosen as the next CEO. I hope that I can serve with transparency and honesty, and with passion for providing patients with the best care possible.

The Beat: Where would you place the Heart Institute in the Canadian landscape of cardiovascular medicine?

Dr. Mesana: There’s no question in my mind that the Heart Institute is a leading institution, but you can’t proclaim yourself number one. Other people have to recognize that.

What we are is due to the outstanding work of our team and to the leadership of my predecessors. Dr. Wilbert Keon was the founder. He had the vision to create a Heart Institute here in Ottawa at a time when cardiac surgery didn’t even exist in the region. He and the Institute’s first generation of staff led the way to what we are now. They worked relentlessly to make the Institute bigger and better. Dr. Keon is an icon of Canadian health care.

Now, Dr. Roberts has left his mark very strongly, particularly in research, and has magnified further the profile of the Institute. The organization has continued to grow under his leadership. But we can never be complacent about the quality of the work we do.

Indeed, we are at the top of the game in many areas, but I am more interested in how we compare to other leading institutions outside Canada, particularly in the U.S. but also worldwide. We have the advantage of being a specialized heart centre, with all of the expertise in one place and a large patient population. This is a unique setting to expand clinical innovation and research.

The Beat: How do you see cardiovascular care evolving in coming years?

Dr. Mesana: On one hand, the population is expanding and aging, so there will be more older and potentially sicker patients entering the system. Heart failure and valvular disease patients in particular will increase, as well as patients with cardiac rhythm disorders, such as atrial fibrillation. On the other hand, the ability and the motivation to prevent heart disease has improved, and we will have to work at the other end of the spectrum to prevent heart disease in young patients who have uncontrolled cardiovascular risks.

At the Heart Institute, our expertise and innovation in minimally invasive procedures, which minimize the trauma of surgery, and other interventions let us treat older, sicker patients and let us do the most complex treatments that no one else is keen to do. We have a reputation for almost never refusing to give care because a case is too difficult or too high risk.

We are seeing more and more patients with a blend of conditions that require a multidisciplinary approach. In the future, I see cardiovascular medicine increasingly adopting a more patient-centred culture in which patients are treated in a coordinated way for the diseases they have rather than being seen as candidates for particular procedures. In other words, rather than having to choose between specialists offering different procedures, patients will have the best procedures recommended for them based on the evaluation of a multidisciplinary team dedicated to their particular conditions. This is part of personalized medicine.

Our TAVI [transcatheter aortic valve implantation] team is a good example of how we are already doing this. In fact, it shouldn’t be called the TAVI program. It should be called the Aortic Stenosis program because the focus is on patients with this condition. Some get a TAVI. Some have conventional surgery because it will work better for them. And some may just continue to be followed by the referring doctor in conjunction with our team of cardiologists, surgeons and anesthesiologists.

Our transplant team is another example. It’s not about heart transplantation. It’s about heart failure. The group includes cardiologists, surgeons, anesthesiologists, physiotherapists, perfusionists, nurses, psychologists. They meet each week to evaluate heart failure patients who may be candidates for heart transplantation. Some may need transplant now, some may need a ventricular assist device and then a transplant, some can be medically managed for some time to come. Some, unfortunately, will never be transplant candidates, so the team will have to find other ways to help them. Everything starts from the patient and what he or she needs.

The Beat: You see care and research as closely linked.

Dr. Mesana: The overall mandate of the Heart Institute is to prevent and treat heart disease. Patients and their families come here to get the best care possible. Research is an integral part of this, especially research that is translated quickly into clinical care, so-called translational research.

In my experience, clinical outcomes research is very important. In an organization like ours, we have a great deal of longitudinal patient data that can be used to assess and improve clinical guidelines. We need to expand our information technology so that we can mine this data more effectively.

I like basic research. I’m an MD with a PhD and have always strongly supported preclinical research. When I was working in the lab back in the 1990s, I always looked for solutions to the unsolved problems I saw every day with patients. I saw the tremendous benefits of a dynamic back-and-forth between the clinic and the laboratory.

We have an integrated institute that combines care with basic and clinical research. That is the incomparable value of the Heart Institute. This and our large patient population give us the capacity to work at the level of the top institutions in the world. We already are in many ways, but we can do more.

The Beat: You bring a strongly international perspective and have led the Heart Institute’s collaboration with the Qingdao Municipal Hospital in China. Why is international collaboration important for the Heart Institute?

Dr. Mesana: By working at the international level, you prove yourself on a stage with the best centres in the world. Based on what we are doing to help Qingdao establish its heart centre, other hospitals in China have approached us. They could be talking to leading institutions in the United States, and some of those have offered to work with them, but they are looking to us. This is a mark of recognition.

The Beat: The much anticipated building expansion is progressing rapidly. What will this mean for the Heart Institute?

Dr. Mesana: This is one of the reasons I was motivated to apply for this position. The new building is a must for patient care, expanding our capabilities and facilities. Our three pillars of care, research and education will benefit equally from this state-of-the-art expansion. It is going to be a major factor for recruitment and for employee satisfaction. It will make the Heart Institute an even more attractive place to work.

The building process will take a few more years and will present challenges. Many things have been achieved already, and Dr. Roberts deserves much credit for that. Yet much remains to be done. We will need to manage the process, stay on budget and be sure we get what we need to remain a world-class centre.

The Heart Institute is one of the jewels of the Ottawa region. We are proud to serve our community and are thankful for their generosity. Their continuing support will be essential for our new building, just as it is to the future of the Heart Institute in general.