Looking for lifesaving changes
Dr. Jean-Francois Légaré strives for better outcomes in cardiac patients
There is always room for improvement when it comes to patient outcomes, and cardiac surgeon Dr. J.F. Légaré is constantly on the lookout for every opportunity to save lives. And according to Dr. Légaré, director of research in Dalhousie Medical School’s Division of Cardiac Surgery, examining the clinical data points the way to concrete changes that make a real difference.
In one study, Dr. Légaré and his colleagues look
ed at acute heart attacks and outcomes in Nova Scotia. “It was a real eye opener,” he says. “We found that 60 per cent of patients with low blood pressure, signifying cardiogenic shock, died in hospital.” In response, the Division of Cardiac Surgery established an alert system that enables physicians in outlying areas to activate the air ambulance service so patients are transported to Halifax in time for life-saving intervention.
On top of his many data-driven investigations, Dr. Légaré conducts clinical studies, including a recent trial of a procedure that enables a patient’s heart to continue beating during open heart surgery. His interests also extend into the realm of basic science, where he is studying post-heart-attack inflammation and its damaging role in congestive heart failure.
“Inflammation is the immune system’s healing response to injury, but it can lead to further, self-perpetuating damage,” explains Dr. Légaré. “Heart cells cannot regenerate themselves, so the ongoing inflammation after a heart attack can have deadly consequences.” By understanding the chain reaction involved, Dr. Légaré hopes to identify molecular targets for new drugs to stop the inflammation in its tracks.
At the same time, he is examining heart tissues from heart surgery patients, to assess the level of inflammation. “We want to know how much the degree of inflammation varies from patient to patient – and if inflammation could be used as an indicator to predict how well a patient will do,” he says. “It may offer clues to improving patient outcomes.”