Two open-heart surgeries utilising cardiopulmonary bypass (CPB) machines with latest technology, were successfully performed recently for the first time at the Jaffna Teaching Hospital, Hospital Director Dr. T. Sathiyamoorthy said in a statement.
The surgeries were carried out by a team led by Consultant Cardiothoracic Surgeon Dr. Sithamparanathan Muhunthan. This is an important milestone in the growth of the Jaffna Teaching Hospital. It is a matter of pride that the Jaffna Teaching Hospital is now one of only four government hospitals where open-heart surgeries are being performed in Sri Lanka, he added.
A thoracic surgery section had functioned at the Teaching Hospital 30 years ago. A team under the leadership of Dr. A.T.S. Paul had performed thoracic surgeries between 1969 – 1970. Later, eminent consultant thoracic surgeons like Dr. Stephan, Dr. R. Natkunam and Rudra Rajaretnam, had worked at the Teaching Hospital, up to 1984.
During this period, cardiothoracic surgeries including minor heart surgeries like CMV – closed mitral valvotomy, PDA ligation, ASD closure, etc., were performed. However, modern facilities for performing the surgery by suspending the beating of the heart, were not available.
It was possible only to do minor surgeries over short periods of time by reducing heart function by cooling the body temperature (hypothermia), without stopping the heart, the Director of the hospital further said.
He said that the facility to perform surgery over a longer period, by stopping the heart completely and maintaining the circulation with the help of modern cardiopulmonary bypass machine (heart lung machine) is now available. Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery by maintaining the circulation of blood and oxygen in the patient’s body. The CPB pump itself is often referred to as a heart lung machine.
The cardiothoracic surgery team consists of consultant cardiothoracic surgeon, consultant anaesthesiologist, consultant cardiologist, assistant doctors, perfusionist (CPB machine operators), nurses and health assistants. Though the first consultant cardiothoracic surgeon to Jaffna, Dr. Sithamparanathan Muhunthan, was appointed over a year ago, the necessary facilities were not available to perform surgery immediately. During this period, he worked at Lady Ridgeway Hospital for children on a part-time basis and was engaged in the establishment of the operating theatre, Intensive Care Unit and obtaining equipment (CPB machine) necessary for surgery.
He also had to make arrangements to get the perfusionist and nursing officers trained, etc. During this period four nursing officers who worked here had gone to the cardiothoracic surgery units of the National Hospital of Sri Lanka and Lady Ridgeway Hospital for children and obtained 3 months’ further training. Health assistants were also sent to these hospitals to obtain training.
“The Jaffna Teaching Hospital is a hospital functioning under the direct administration of the Central Health Ministry in Colombo. Health Minister Dr. Rajitha Senaratne, the Health Services Director General, and higher officials of the Health Ministry, have given the necessary suggestions and assistance to perform heart surgeries at our hospital, this year.
The Health Ministry is taking action to appoint a complete cadre of staff and establish a new building complex during the coming year,” the director said.
The director thanked the Colombo National Hospital, Lady Ridgeway Hospital, Teaching Hospital Kandy and Karapitiya Hospital for helping to start the heart surgery in Jaffna by providing training to his team of nurses and perfusionist and for temporarily releasing two perfusionists who operate the heart lung machine.
The director went on to say though the Ministry of Health had appointed a cardiothoracic surgeon in the early part of 2017, it has not appointed separate anaesthesiologists and other doctors.
At present, only two doctors have been appointed to the unit. Despite the shortage of staff in the department of anaesthesiology at the Teaching Hospital Jaffna, the anaesthesiology department helped to perform the surgeries by end 2017.
“We have been planning during the past year to construct a separate building complex with complete staffing and equipment for cardiothoracic surgery at the Jaffna Teaching Hospital,” he added. “In the meantime, the Central Health Ministry had taken action to purchase a CPB machine worth Rs. 30 million. We will receive that machine soon.
However, until we receive that new machine, Hemas Surgical and Diagnosis which sells Terumo machines, helped initiate the surgery early in 2018 by loaning the machine they had. Only a section of the Intensive Care Unit (CT/ICU), with two beds for management of post-surgery patients, is currently available at the hospital.
Therefore, heart surgeries could be performed better when a permanent building complex is constructed.”
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