Local heart institute makes history with angioplasties By Iana Seales
Stabroek News
February 3, 2007

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The team from the Caribbean Heart Institute which performed the angioplasties yesterday.

The Caribbean Heart Institute (CHI) located in the Georgetown Public Hospital made medical history in Guyana yesterday by completing three angioplasties with the assistance of a team from the US.

Angioplasty is a non-surgical procedure to widen and clean out blood vessels using balloon dilation or laser treatment. The three local patients had vascular stents inserted in their arteries where blockages were earlier detected, and up to last evening were in good condition and resting well.

Dr Bilal Malik, an Interventional Cardiologist from Maimonides Medical Centre in the United States carried out the procedure along with Dr Gary Stephens, Cardiologist and Chief Executive Office of the institute. Accompanying them were Radiation Technologist, Richard Casazza and Senior Nurse, Anastasia Giglio and a few resident staff at the institute.

Dr Malik who had seen the patients' records while still in the US and met them yesterday after arriving in the country said everything went smoothly as expected. He said the cardiac institute is equipped to carry out various operations and referred to angioplasty/stenting as one of the procedures which the institute was capable of handling for sometime now.

He noted though that expertise is important, which is why he and his team were involved. However, he pointed out that the team working at the institute headed by Dr Stephens and Dr Haydock Wilson is competent. On a normal day, Dr Malik said, his hospital in the US does around 20-30 interventions a day. At present, the local institute has the capacity to do three a day and Dr Stephens told Stabroek News there is a waiting list of around 20 patients, which represents 80 percent of the persons the institute would have evaluated within the last four months.

The cost of the procedure varies depending on the number of stents a patient requires but the figure could be anywhere between US$2,000 and US$5,000.

Stephens said the stenting being done here is referred to as bare metal stenting and involves the insertion of a wire mesh tube during angioplasty to prop open an artery. He said it requires taking medication for a period of time after completing the procedure.

According to him, there is a risk of the stents getting infected so patients have to be monitored to ensure they are taking the medication.

In the months the institute has been seeing patients, Stephens said, some persons have turned up with severe problems.

However, the institute is currently not in a position to offer emergency invasive procedures and unfortunately some persons who visited did not make it.

But the institute is working to get there, he added. He said the idea is not to rush anything but to take it one step at a time. Currently the focus is on reducing the backlog of patients awaiting vascular stenting.

The Caribbean Heart Institute which opened its doors to the public in October 2006 has pledged a comprehensive cardiac care programme in Guyana. The institute has not set any specific time line but it has promised open heart surgery, valve replacement and balloon angioplasty among other things. The institute boasts a four-bed coronary care unit, digital catheterization lab with electrophysiology capability, operating room for cardiac surgery, a networked computer system, electronic medical records and a team of trained technicians. To date the institute has seen and treated in excess of 200 patients with various heart ailments. Treatment up until yesterday had been non-invasive and included holter monitoring (a machine that continuously records the heart's rhythms), EKG testing (a test that measures the electrical signals that control the rhythm of the heartbeat) and ultrasound.

CHI has struck an arrangement with the government for the establishment of cardiac care here.

A number of Guyanese doctors with many years of experience are included in the team but this is CHI's first project as a unit.