Heart Institute warns thousands of heart surgery patients of risk of infection

The Ottawa Heart Institute has sent letters to 5,500 patients who in the last five years had open heart surgery, warning them they may have been exposed to an infection from a machine used during the procedures.

• Equipment tied to Quebec health scare used at Ottawa Heart Institute
• 6 Quebec hospitals warn heart surgery patients of potential infection risk

The risk stems from problems cleaning a contaminated piece of operating room equipment, which is used during open heart surgery to keep a patient's body at exactly the right temperature.

The letter was sent to all of the patients who had the surgeries going back to 2012. The institute says the device, called the Sorin 3T Heater-Cooler, has been associated with a rare infection caused by non-tuberculosis mycobacterium (NTM).

It's the same equipment issue that prompted six Quebec hospitals to contact more than 23,000 patients about a potential risk of infection.

While the institute said the risk of infection is "very low," it warned it is difficult to detect and may manifest months —or even years — after being exposed to the bacteria.

Symptoms include:

• Night sweats.
• Muscular pain.
• Weight loss.
• Fatigue.
• An unexplained fever.
• Redness, heat or pus around the chest incision.

The infection is generally not fatal, but can be dangerous for people already in a weakened state after surgery.

The institute acknowledged in its letter that patients may be worried and have questions, and asked patients to call them at 613-761-4322.

Changes made after learning of contamination

Dr. Marc Ruel, the division head of cardiac surgery at the institute, said once they learned about potential issues with the machines they took precautions, including sending some of the heater-coolers to the factory in Germany for deep cleaning.

They also changed how the fans were used, pointing the exhaust away from the patient and towards a back wall.

"It may sound trivial but it actually may be a very important factor and it could be the single most important factor explaining why — touch wood — no infection has been reported in the cohort of Ottawa patients," said Ruel.

But Ruel said they are treating the risk seriously, as the infection is hard to treat with antibiotics and the treatment itself may require surgery.

"It's an agent that we don't, as clinicians, as heart surgeons, have a lot of experience with but it's an agent that lives everywhere that water is warm," he said.

In the U.S., the contamination, which the institute said happened during the manufacturing in Germany, has been tied to at least 28 cases of bacterial infection.