Heart institute angling to up bypass operations

-four completed over weekend

An ambitious undertaking by the Caribbean Heart Institute (CHI) and the public hospital to increase the frequency of bypass surgeries here is expected to bear fruit in another few months when a largely local team will perform the operations.

Dr. Gary Stephens of CHI said the institution is focusing on cutting the numbers on its waiting list for open-heart surgeries, which remains substantial, in addition to building capacity here.

Specifically, he said that it is a bit early for a local team to undertake a heart valve operation given the technicalities involved, and therefore the initial focus is on by-pass surgeries.  He noted that CHI would eventually phase out its overseas team for the surgeries, but emphasized that the expertise of at least one overseas professional to operate the heart-lung machine is required.

In the years that CHI has been in operation, Dr. Stephens said, it has managed a couple of surgeries but not with the frequency it had hoped. This, he said, is due to the fact that the institution has an overseas surgical team coming in every few months.

The team was here last week and performed four bypass surgeries. The patients, Jasmat Ramanand; Ved Anand Lallbeharry; Leonard Wharton and Dr. Laxa are said to recovering well and are expected to return home shortly.

Dr. Stephens said the surgeries were conducted over the weekend beginning on Friday and wrapped up on Sunday. He noted that the four patients were taken from a long waiting list, adding that CHI, which is based at the Georgetown Hospital, is eager to collaborate with the public hospital and offer more routine bypass surgeries.

Speaking during a recent interview with Stabroek News, he singled out medical professionals at the local level such as Dr. Alexandra Harvey and Dr. Madan Rambarran as being among the capable hands that will work along with CHI to have the surgeries done, but more importantly increase the frequency of surgeries to once every month.

But even as the institution moves in this direction, Dr. Stephens was cautious to point out that CHI still faces challenges, particularly as it relates to lab work. He said that the institute often requires prompt results and pointed out that this would sometimes take hours.

He said, too, that greater government oversight is needed in the system because there is a record of patients failing to receive coronary care within the system despite CHI having the facilities to treat them. Dr. Stephens said that doctors are simply not referring patients, but he noted that in some cases it is due to doctors not being aware of what is available at CHI.

With respect to awareness, he said, that CHI has failed to aggressively go after educating the public on what services are available. He was optimistic that the institution will improve in this area because “people’s lives often depend on what they know”.

Further, the CHI head noted that they are at the stage now where pace-making capabilities are strong, adding that pacemakers would soon be in stock and ready for patients, moving away from the old system where pacemakers had to be ordered.

He added that the patients who had surgeries at CHI to date have done well except for one patient who died last year. According to him, the patients are taking their post-op care seriously and are sticking to medication in addition to going in for regular check-ups.
Paediatric surgeries

Dr. Stephens is projecting that CHI would be in a position to perform the first round of paediatric heart surgeries in Guyana shortly with the assistance of a medical team from the US.

Though Guyana does not have a huge problem with congenital heart disease among children, he said, there are children out there suffering and estimated the figure to be around 70. Of deeper concern, he said that there are children with complex heart issues who are not likely to be treated here even when the services are available because of the complexities.

He mentioned one little girl on CHI’s patient list who has no arteries going to her lungs.

According to him, she is not likely to be treated in Guyana because the facilities are not going to be here anytime soon.

He said that CHI is largely targeting children who would have in the past gone to India and received treatment, and pointed out that the institute is expecting local charities to show the same level of support to the children because CHI has to attach a cost.

Since it has been in operation close to 50 children have visited the institute with various heart problems and based on the need a decision was taken to have them operated on. He said that a heart surgery team in the US is interested in coming down to Guyana to operate on the children later this year.

Through collaboration with the Long Island Jewish Hospital, which is part of the North Shore Hospital, CHI will facilitate the surgeries. He said that the information on the children’s medical conditions would be forwarded to the US so that the doctors can evaluate the cases.

Dr. Stephens noted that since the team would be a large one the plan is to have close to a dozen surgeries completed during the period they are here to “make it worthwhile and treat as many children as possible without rushing things”.

CHI opened its doors to the public in October 2006 and had promised a comprehensive heart care programme. Stenting which involves the insertion of a wire mesh tube during angioplasty to prop open an artery and angioplasty were among services phased in by the institute prior to bypass surgeries.

Dr Stephens had previously stated that persons who are approved for the surgery would be given a package deal and a separate deal for the medication. The CHI has an arrangement with the Government and private sector. Members of the public are being facilitated for surgery through the efforts of the Ministry of Health. Surgery is being offered at a cost far less than it would be overseas.

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