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Donor supported program brings cardiac treatments to patients.

There’s never a good time to have a heart attack, but there is a good place to have one. Thanks to the cutting-edge work done at the University of Alberta Hospital’s Mazankowski Alberta Heart Institute (Maz), Edmonton is the best place in Canada — and possibly the world — to be when a heart attack strikes.

A heart attack occurs when blood flow to the heart becomes blocked. When that happens, seconds can mean the difference between severe heart damage and no obvious damage. It is the difference between life and death.

With funding provided by generous donors to the University Hospital Foundation (UHF), heart specialists at the Maz have the ability to advance patient care and take healthcare innovation to new heights, including the development of the Vital Heart Response Program (VHR).

Based on research led by Maz cardiologist Dr. Robert Welsh and developed with Edmonton colleagues, the VHR Program is a game-changing system that takes life-saving treatment to patients, rather than waiting for heart attack victims to arrive at a hospital for diagnosis and treatment.

“One of the key things for treating heart attacks is time,” says Dr. Welsh, who came up with the idea in 1999 while training as a resident. “We built a system of activating care wherever a patient presents.”

To make the most of every minute a patient has, the VHR Program integrated ambulances into the spectrum of care for heart attack patients. Under the remote direction of a team of Edmonton cardiologists, northern Alberta paramedics — some of the most highly trained in the world — can receive approval to administer clot-busting IV drugs en route to the hospital.

The VHR Program is used specifically for STEM (“ST-elevation myocardial infarction”) heart attacks, which mainly affect the heart’s lower chambers. It is one of the most severe and dangerous types of heart attacks.

The program is now offered in every ambulance and community hospital in central and northern Alberta. It has had such an impact on patient outcomes over the last 15 years that it is being copied and examined in major cities around the world.

“There’s a thousand people each year — your friends and neighbours — having these events whose outcomes are improved by this program,”

“Usually, a STEMI heart attack has twice the risk of death (as a non-STEMI episode). We’ve taken the one that is supposed to kill twice as many people and reduced it to the point where it doesn’t. The patients not only survive, but frequently underestimate the risk, saying, ‘That wasn’t so bad.’” says Dr. Welsh.

Today, the VHR team is looking for additional ways that innovation and technology can save even more lives. With help from the UHF, Edmonton collaborative researchers are taking bench research on the use of doxycycline and bringing it directly to heart attack patients to improve outcomes.

“There’s also a new study coming up of a new antiplatelet that we’ll deliver in the ambulance through injections,” Dr. Welsh says. New treatments are well placed at the Maz, which is home to state-of-the-art technology. It has the only cardiac hybrid operating room of its kind in Alberta, allowing cardiac surgeons and cardiologists to work on the same patient at the same time to provide the best care.

Its Cardiovascular Intensive Care Unit (CVICU) has proven one of the best in Canada for providing advanced cardiac and respiratory mechanical circulatory support.

The program is now offered in every Ambulance and community hospital in central and northern Alberta. It has had such an impact on patient outcomes over the last 15 years that it is being copied and examined in major cities around the world.

The institute also has the largest adult and pediatric heart-lung transplant program in Western Canada — ranked an impressive sixth in the world for transplanting excellence in clinical care and research. It is a centre for the brightest of minds seeking bold solutions and transforming health.

Dr. Welsh says he’ll never stop striving to ensure the Maz remains Canada’s gold standard for heart attack treatment.

“Even though we’re one of the best in the world — if not the best — we’ve never stopped trying to get better. We just keep pushing forward.”

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