CHI completes three more open heart surgeries – team targets four a month, larger ICU needed

Three open heart surgeries were completed within the past three days at the Caribbean Heart Institute (CHI), which is seeking to make the procedures routine by the end of the year.

With a waiting list of some 40 local patients, CHI, which is located at the Georgetown Public Hospital, has a planned schedule of four surgeries a month starting in another few weeks. Though CHI’s capacity allows for eight surgeries a month in a four-day period, the institute’s Intensive Care Unit can only accommodate four patients.

“Space has been an issue for us for some time now and it is also not within our hands. The hospital’s administration has to make that call but we definitely need a bigger ICU,” Chief Executive Officer of CHI Dr Gary Stephens told the Sunday Stabroek yesterday.

Stephens, a US-based Guyanese cardiologist, led a team of US doctors and nurses last week in the second round of open heart surgeries to be completed in Guyana. The patients were, Makebarran Ramdin, Ramnaught Sanichar and Janet Yassin.

Ramdin had a single bypass surgery on Thursday night; Sanichar, a double bypass surgery on Friday and Yassin had a valve replacement early yesterday morning. All three, were said be in a stable condition and resting at CHI yesterday. However the first 24 hours were listed as critical for Yassin.

CHI’s team included Dr Stephens; cardiologist Dr Sunil Abrol; cardiac anaesthesiologist Dr Ronald Gray; Physician’s Assistant Vesta Bascom; Operating Room (OR) Nurse Phillipa Gibson; Rosamond Bobb-King, RN and Rookmin Rampersaud, RN.

Stephens noted that CHI had four surgeries planned but aborted the fourth after one took particularly long to complete. He said they spent close to eight hours in the operating room on one patient given that some members in the team were now getting familiarized with the equipment.

Since the first open heart surgery in October, he said, they have made tremendous progress but pointed out that there are a few areas they need to work on. Stephens said the areas are more procedural than infrastructural. He said they were able to complete Ramdin’s open heart surgery without the use of the heart lung machine (takes over for the heart by replacing the heart’s pumping action and by adding oxygen to the blood), which means the surgery was done with his heart beating. However, the machine was used in the two other cases.

According to Stephens, CHI had delayed the second round of surgeries because it was awaiting the shipment of an electrical operating table for the OR. The table arrived only recently and it was installed in the OR on Thursday last.

Not eligible

Within the past few months CHI has had to tell a few patients on the waiting list for surgeries that they are no longer eligible. Stephens said such a decision is always taken with the patient’s safety in mind. In a few cases, some of the patients suffered heart attacks among other complications and are still recovering. As for who gets priority when it comes to surgeries, he said it was a first-come, first-served policy but some critical patients are often bumped up the list. CHI’s current focus is on having open heart surgeries once a month, according to Stephens. He said they hope to operate on four patients every session, which is the amount the ICU can accommodate currently.

Stephens revealed that when open heart surgeries are being done the institute is forced to halt angiograms because the ICU cannot hold everyone. He said CHI does around 20 angiograms a month.

From his hospital bed, Makebarran Ramdin told Sunday Stabroek he is grateful to God, his family and the team at CHI for “giving me back hope and my life”. He said that his heart problem left him in pain and unable to do regular work since last year, now he is anticipating returning to work in another few months.

Ramdin, a rice farmer from Cane Grove, Mahaica, said government acted wisely in allowing CHI to set up in the country and offer the service. He revealed that he had been on the list since last year and was supposed to have had the first open heart surgery but he fell ill a few days before the date and could not be considered anymore.

“I was ready for this since last year but God planned it in he own time. I am so happy that my family is here and I didn’t had to go overseas where I would have missed them dearly. Added to that, I was able to afford this surgery,” Ramdin said.

Ramdin could not stop sounding praises for Dr Stephens and the CHI team, who he said, were beyond wonderful.