“Oneof the most outstanding things in my memory is the first artificial heart transplant in Canada,” recalls cardiovascular surgeon Dr Arvind Koshal of the time, a quarter century ago, when he trained at the Ottawa Heart Institute with Dr Wilbert Keon. “We had just received our training for the Jarvis heart transplant. A young woman was in the operating room. In any other circumstances, she would have been declared dead, because she had a massive heart attack. I was part of the team of cardiovascular surgeons who translated that historymaking Jarvis artificial heart and saved her life.” It was, he recalls, a time of considerable anxiety. They had to wait seven days before replacing the human heart with an artificial one. But such patience was rewarded when the surgery progressed smoothly.
“The patient survived, and lived for some 18, 20 years,” says Koshal, listing it as one of those experiences no one who was part of it can ever forget. The first ever artificial heart transplant in Canada naturally generated considerable media buzz, and “That made a huge impact on us on the use of an artificial device, particularly their useful role as a bridge to transplantation,” says Koshal. That experience proved seminal. Thus, when he became Director of the Division of Cardiovascular and Thoracic Surgery at the University of Alberta in Edmonton, and surgeon- in-chief, cardiovascular surgery at the University of Alberta Hospital in 1991, he envisioned and promoted the development of “an outstanding cardiac institute in Edmonton.” Thanks to his belief and drive, Alberta now has the Heart Institute, a 600,000 sq. ft building that has 132 beds, all for cardiac patients, which Prime Minister Stephen Harper had inaugurated and which opened its doors to patients in July this year. The Institute became possible when in 2001 the Government of Alberta recognized the Cardiac Sciences Program in Edmonton to be a Center of Excellence, for which an initial sum of $125 million was allocated. Interestingly, the community raised $37 million for the project and buoyed by this, the Alberta government added an extra $22 million to complete the project. “This is paying for the future,” he says about the Institute. “It brings me a tremendous sense of fulfillment; I feel so humbled when I look at this building.” That sense of achievement was further heightened when his former boss and mentor Dr Keon visited him in Edmonton, and told him ‘’’There won’t be another heart institute in Canada like this one.’
For all his developmental work, Koshal is at heart a surgeon, who estimates that during his 32 years in practice he has performed at least 8,000 bypass surgeries. He uses the conventional method, where the heart is stopped after the patient is hooked to the heart-lung machine – a method he believes is safer than the more modern beating heart surgery. Safe does not however mean fool-proof, says Koshal, admitting that he has lost the odd patient during his career. “Our mortality rate is 1 to 2 percent, which is acceptable. Some people are in very desperate straits – no matter what you do, you cannot save them. But by and large, it is very unusual now to lose a patient on the table.We have so many things that we can do now, but medical science is still not perfect.” He has published extensively, and been widely honored. In 1994, he received the Wilbert J Keon Award for outstanding contributions in the field of cardiovascular medicine, and in 1999 he was elected president of the Canadian Society of Cardiac Surgeons. He recalls how he was attending a wedding in Goa last November, when the call came in to inform him that he had been named for the Order of Canada award for 2008. The citation that came with the award said he was being named for his ‘contributions to the field of cardiac surgery in Canada, notably in performing several innovative techniques, and for his leadership in developing one of the leading cardiac care programs in the country.’ “With all these recognitions and a sense of fulfillment that the Alberta Heart Institute has finally opened its doors, it is nice to keep my head down and keep working,” Koshal says. “There’s lot of work yet to be done. I have to make sure that the Heart Institute really runs well, and it really becomes world class center that I wanted it to be.”
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