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Few patients are truly glad to see Terry Yau. He may be kind and thoughtful, but this softly-spoken heart surgeon is also many people's last hope. And all too often, he has to explain there's nothing he can do. A lack of donors means 99 per cent of potential transplant recipients don't receive an organ. Others can't have surgery because of complications. "It's a miserable life," Dr. Yau said. "Instead of living, they're just waiting to die. That's the thing that I hate the most."

So Dr. Yau is finding new ways to help.

At the Peter Munk Cardiac Centre, he is researching turning bone-marrow stem cells into preliminary heart cells. If successful, these "supercells" could be injected into a damaged heart area, where they would make the full conversion from heart-like stem cell to a regular heart cell. "Ultimately, the idea would be to rebuild a completely normal heart," Dr. Yau says.

Toronto researchers have long been interested in stem cells, even though other researchers often regarded their early work

as crazy. In 1996, researchers at the Toronto General Research Institute and University of Toronto were the first to show a heart's pumping function could be improved by transplanting cells instead of a whole heart. Then in 2001, a separate finding showed that modified cells could boost blood flow. Now, the method that was once thought of as crazy is an accepted fact.

Late last year, Dr. Yau announced a new advance: The genetically modified supercells work in rats. This year, his team will test them in pigs. If that works, testing will progress to humans.

In the meantime, Dr. Yau is hoping to combine two current therapies to gain better recovery rates for patients. First, a laser would punch holes in the heart muscle — a system used in the United States to improve blood flow through blocked muscle — and then unmodified stem cells would be transplanted into the prepared zone. If the therapy is approved by Health Canada, Dr. Yau is aiming to start trials involving the genetically modified supercells later this year.

Through his work, Dr. Yau hopes to change the current reality of heart failure, which strikes 500,000 North Americans each year. "You can't reverse [a heart attack] no matter how many bypasses you put into them," he says. "Heart attacks are always a permanent thing."

But with these new approaches, Dr. Yau is hoping to change that reality, make hearts repairable and have some good news the next time someone knocks on his door.

"[A patient] may not feel like she's 20 years old again, but she'll be able to go walking with her family, go shopping and live better," Dr. Yau says. "You or I don't need a super heart. All we need is a normal heart that doesn't get worse."