Dr. Liane Porepa completed her medical degree and internal medicine residency at the University of Toronto and her cardiology residency at the University of Western Ontario. She then went on to complete a fellowship specializing in advanced heart failure, cardiac transplantation and mechanical circulatory support (mechanical heart) at the Cleveland Clinic Foundation in Cleveland, Ohio. It is this fellowship that brought her north to Newmarket.
When Dr. Porepa came to Southlake in September 2013, she knew, despite her training in the management of patients with heart transplants and mechanical circulatory support, she was coming to a cardiac program that doesn’t offer these procedures. However, she had other plans to utilize her training—providing assessment and management support to patients in the Southlake catchment area who had, until now, had to travel to Toronto to receive care in an advanced heart failure clinic. These are the patients who have been identified as potentially needing a heart transplant, or, mechanical assist device. As Dr. Porepa attests, this is a patient group growing in numbers.
Heart failure can be the end result of other heart issues including valves, arteries and electrical problems . When the heart muscle fails it ccan’t pump or relax properly. While cardiologists and technology have gotten better at treating heart conditions, the heart is a muscle and sometimes it eventually wears out.
At times heart failure can be treated with medication, other times greater intervention is needed. “I see mechanical devices as the last frontier of cardiac intervention,” Dr. Porepa says.
Left ventricular assist devices (LVADs), sometimes referred to as mechanical hearts, are surgically implanted to pump blood from the left ventricle to the aorta. Sometimes LVADs are intended for short-term use; other times they will stay with a patient for life, particularly to treat advanced congestive heart failure.
Today Dr. Porepa has her own cardiology practice and works with patients in the heart function clinic who may someday be a candidate for transplant or LVAD. Patients no longer have to travel to Toronto for advanced heart failure management. These patients can be assessed by Dr. Porepa and then referred downtown if the need for intervention becomes certain. Once the intervention has occurred, patients can then come back into Dr. Porepa’s care. She has become an invaluable bridge.
This is a tremendous boost for these especially vulnerable patients and is a service Dr. Porepa would like to see extensively utilized. Recently she had a patient in severe heart failure referred to her by a hospital in the far corner of Southlake’s catchment area. Dr. Porepa assessed the patient and knew immediately that an LVAD was imminently needed. For this patient, the last frontier turned out to be a lifesaver.
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