Quantum leap for cardiac care
-over 100 children benefit from advanced technology
By Heppilena Ferguson
Stabroek News
April 21, 2007

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Paediatric care in Guyana has taken a quantum leap with the screening of over 100 children with cardiac complications and interventions in nine of them during the last week through another collaborative effort of the Caribbean Heart Institute (CHI), the Georgetown Public Hospital and the Government.

All the interventions were done using cutting edge technology without surgically opening the chest, a process called digital catheterization, used for the first time in the history of the English-speaking Caribbean, CHI Director Dr. Gary Stephens said at a press conference yesterday.

Dr. Charles Gaymes, an interventional cardiac electrophysiologist and Dr. Makram Ebeid, an interventional paediatric cardiologist, who are attached to the University of Mississippi Medical Centre in the United States volunteered their services to the programme and provided specialized care to a number of Guyanese children.

Dr. Ebeid told the media that when he first came to Guyana to be part of the programme he was not too optimistic about the objectives being fulfilled but he was pleased that everything turned out to be successful. He is versed in utilizing cardiac technology and said that many of the cases which he dealt with during the programme were a combination of complex, moderate and normal lesions.

Ebeid said one of the children he dealt with had extremely large blood vessels and could have succumbed to severe lung disease hadn't he received treatment.

Another child, he said, suffered from a large hole in his heart and through the treatment and without incisions in the chest, the hole was closed and the child would be able to live a normal life.

The doctors also said they performed a number of other interventions without surgery.

Dr. Gaymes explained however that there were a number of children, because of the amount of time that had elapsed between their birth and the discovery of the defects, who could not be assured a safe procedure and so they did not take any chances.

Children who had also undergone heart surgery in India under the Kids First Fund initiative were also evaluated by the doctors. However some who have been recommended for open heart surgery will still have to fly to India for this.

Minister within the Ministry of Health, Dr. Bheri Ramsaran, who has been instrumental in the co-ordination of the programme, was also present at yesterday's media briefing at which he noted that the programme is now a sustainable one.

Asked about the cost to government, Ramsaran said the government had to come up with US$20,000 initially but there were also tangible costs such as in-country costs and support for the medical team.

"However a significant contribution was the specialists which was truly a joint effort and we are grateful for their outstanding contribution since if these children had to travel overseas it would have cost much more money," the minister said.

The doctors hope to return to Guyana in another six months but the local medical team has assured that they are currently in the process of mobilizing personnel to fill the gaps and have a continuous presence of specialists.

CHI director Stephens pointed to the state-of-the-art technology used in the process and expressed his satisfaction with the way the children reacted to the treatment and "were practically ready to go through the doors just hours after they were treated."

He said the morning after treatment the children received their post-operation [post-op] care and were discharged. A number of persons have turned up at the facility at the GPHC with severe problems but the institute is currently not in a position to offer emergency invasive procedures and unfortunately some persons who visited have not survived.

But the institute is working to get there, Stephens 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. He said yesterday that the collaborative effort had made great strides in the last six months.

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 timeline 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 network 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 has so far 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.