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Questions and answers for patients who have had an open heart surgery

Q: How long has the MUHC been aware of this situation?

A: In 2015, the McGill University Health Centre (MUHC) and several hospitals in North America were informed of the risk of mycobacteria contaminating some devices (heater-cooler devices) used during open heart surgery that requires extracorporeal circulation. As a result, the MUHC implemented stringent measures recommended by the suppliers of the equipment to reduce the risk of infection. In October 2016, the MUHC was informed that two patients at the Montreal Heart Institute had been infected.

Q: What are the sources and the risks of infection?

A: The manufacturer has confirmed that their devices built before September 2014 were contaminated by the Mycobacterium chimaera bacteria, during production at the factory in Germany. This bacterium was identified as the probable cause for an infection in a small number of patients worldwide who have had open heart surgery. Symptoms of infection with this bacterium may appear up to five years after the heart surgery.

Q: Should I postpone my surgery because of the risk of infection?
The risk of bacterial infection at the surgical site is always present during open heart surgery. In the case of Mycobacterium chimaera, the risk is minimal – less than 1%. On the other hand, the risks associated with not having surgery are far greater. If you have any concerns before undergoing surgery, we suggest that you mention them to your doctor.
Q: Devrais-je remettre mon opération à plus tard à cause du risque d'infection?
Le risque d'infection bactérienne du site opératoire est toujours présent avec toute chirurgie cardiaque à cœur ouvert. Dans le cas du Mycobacterium chimaera, le risque est très faible (de moins de 1 %). Par ailleurs, les risques associés au fait de ne pas être opéré sont nettement plus grands. Si vous avez des inquiétudes quant à votre opération, nous vous suggérons de les mentionner à votre médecin.

Q: Should I postpone my surgery because of the risk of infection?

A: The risk of bacterial infection at the surgical site is always present during open heart surgery. In the case of Mycobacterium chimaera, the risk is minimal – less than 1%. On the other hand, the risks associated with not having surgery are far greater. If you have any concerns before undergoing surgery, we suggest that you mention them to your doctor.

Q: Can the devices used today still present a risk for future surgeries?

A: Fortunately, with the opening of the Glen site, most of the MUHC equipment is new and was manufactured after September 2014. These were certified to be free of mycobacteria by the manufacturer, upon delivery. Over the years, some patients were operated with equipment that was manufactured prior to this date. No MUHC patient has developed an infection at this time. Machines originating prior to September 2014 will be removed and replaced as soon as possible. We also conduct monthly microbiological verification on all devices, as suggested by the manufacturer.

Q: What are the symptoms and how can we detect this infection?

A: The symptoms associated with this infection are non specific but last for a prolonged period of at least two weeks and include:

  • Fever, night sweats
  • Unexplained weight loss
  • Muscle and joint pain and fatigue
  • Enlarged lymph nodes
  • Persistently draining surgical wound

If you have any of these symptoms for more than two weeks, a medical investigation is warranted and may include microbiology cultures to confirm the diagnosis to see if the symptoms are due to infection by Mycobacterium chimaera. Preventive screening is not useful since in the absence of symptoms, the bacteria cannot be detected.

Q: What should I do if I have these symptoms?

A: If you have these symptoms for more than two weeks, we recommend that you contact us at 1-888-996-9088. Please leave a message with your name, telephone number and hospital card number. A health professional will call you back as soon as possible.

Q: How can we treat this infection?

A: If the medical assessment and analysis confirm a diagnosis of Mycobacterium chimaera, an antibiotic treatment is available and would be prescribed.

 

For more information

Notice to MUHC patients who have undergone open heart surgery

Letter to patients

Notice to Patients: Risk of Contamination from Open-Heart-Surgery Devices