News
New Year cheers for northern heart patients
With open heart surgery being performed with the latest technology for the first time at the Jaffna Teaching Hospital this week, the New Year will bring hope to numerous patients in the Northern Province.
Well on the way to recovery: The two patients and the doctors in the Intensive Care Unit after open heart surgery.
“We performed open heart surgery on two patients on Wednesday and Thursday,” Consultant Cardiothoracic Surgeon Dr. Mugunthan Sithamparanathan told the Sunday Times, explaining that the 27-year-old man and 22-year-old woman underwent closure of holes in the heart, in surgery where a heart-lung machine was used.
Dr. Mugunthan said that the heart-lung machine (cardiopulmonary bypass machine which takes over the functions of the heart during the operation) was loaned by the company from which the Health Ministry has ordered a new machine for the Jaffna Hospital. The company has given the use of this machine until such time that the new heart-lung machine is installed in about two months.
The patients who underwent open-heart surgery were a trader from Vavuniya who had been diagnosed with an atrial septal defect (ASD) when he was 12 years old and a housewife from Kilinochchi diagnosed with the same condition at the age of three. Both had ASDs or holes in the wall between the two upper chambers of the heart and surgery was required to repair them, it is learnt.
Explaining what happens when a person has an ASD which is congenital (present from birth), Dr. Mugunthan said that freshly oxygenated blood flows from the left upper chamber of the heart (left atrium) into the right upper chamber of the heart (right atrium). Here the oxygenated blood mixes with deoxygenated blood and is pumped to the lungs. This results in extra blood overfilling the lungs and creating a strain on the heart.
“If this condition is not treated, the right side of the heart becomes enlarged and weakened, while the blood pressure in the lungs rises, creating pulmonary hypertension,” he says.
The open heart surgery -- in which the heart-lung machine was used -- in progress to close the hole in the heart.
The patients had been on the waiting list for their heart operations for a long time, like 360 others, he said, adding that if open heart surgery was not initiated at the Jaffna Hospital they would have been compelled either to travel to the National Hospital of Sri Lanka (NHSL) in Colombo at much inconvenience and cost or get it done in the private sector at a high cost (between Rs. 500,000 to Rs. 650,000), which many of them could not afford.
Currently, in the state sector, open heart surgery for adults is limited to the NHSL and the Kandy and Karapitiya Teaching Hospitals. However, since December 1, no such surgeries are being performed at the NHSL due to two of the Cardiothoracic Operating Theatres (OTs) being under prolonged repair and the other two OTs posing the danger of infection.
Meanwhile, some of the challenges the Jaffna Hospital will have to deal with as it embarks on open-heart surgery are having a dedicated staff and more Intensive Care Unit (ICU) beds. The Sunday Times understands that for the two operations performed this week, the Health Ministry had sent perfusionists from the Kandy Hospital and the NHSL respectively.
With regard to ICU beds, at present only two are dedicated to patients who have undergone open heart surgery. As such, more surgeries can be performed only when those who have already had surgery are moved to the ward from the ICU, it is understood.
“Slowly and surely, we will expand the facilities,” says Dr. Mugunthan who had been posted to the Jaffna Hospital to set up the infrastructure for open heart surgery nearly two years ago, working two weeks there and two weeks at the Lady Ridgeway Hospital (LRH) for Children in Colombo.
The team which performed the first-ever open heart surgeries and attended to the two patients at the Jaffna Hospital includes Surgical Assistants Dr. M. Navaneetharan and Dr. N. Sriskantharajah; the Anaesthetic Team headed by Consultant Anaesthetist Dr. S. Premakrishna; the ICU doctors Dr. K. Uthayaseelan, Dr. K. Sathiyendran, Dr. P. Hinthuhasan and Dr. K. Shobiya; the Cardiology Team; Perfutionists E.M.S.N.K. Ekanayake, U.G.K.B. Gunasekera, P.G.R.W. Wasantha Kumara and M.A.I. Weerarathne; the Nursing Team headed by B.I.V. Rameshkumar and the Health Assistants.
Appreciating all those who extended a helping hand in setting up the facilities, he says that unstinting support was forthcoming from Health Minister Dr. Rajitha Senaratne; Health Ministry Secretary Janaka Sugathadasa; newly-appointed Health Services Director-General (DG) Dr. Anil Jasinghe; Deputy DG Dr. Lakshmi Somatunge; and Jaffna Hospital Director Dr. T. Sathyamoorthy.
The male patient and the doctors before open heart surgery.
Reiterating that all his colleagues were very supportive in this endeavour, with the NHSL and the LRH training the Jaffna nurses and the NHSL and the Kandy Hospital providing the perfusionists, Dr. Mugunthan is also grateful to Heart Surgeon and Oxonian Heart Foundation (OHF) Chairman Dr. Ravi Perumalpillai for providing invaluable advice and Terumo Business Manager Dilan Silva for providing the heart-lung machine in advance.
It was Dr. Perumalpillai — after retiring from the prestigious John Radcliffe Hospital in Oxford, England — who took up the quest of establishing the non-profit OHF and initiating open-heart surgery at the private Northern Central Hospital (NCH) in July 2014. The arrangement with the NCH is that for every five to seven patients who will pay for cardiac surgery, one needy person will be able to get a heart operation done free of charge. The surgeries of some others, depending on their financial straits, are also subsided by OHF.