OPEN HEART SURGERY
International Hospital has just carried out the first two cases of open heart surgery in Uganda. These were the repair of atrial septal defects (ASD) commonly known as a hole in the heart.

The first case was carried out on Friday 13th on Atwine Mark, a thirteen year old boy from Bushenyi, who was first diagnosed with a hole in the heart aged nine. The second case was carried out on Sun 14th on David Kalenjera, a seventeen year old boy who was diagnosed in January 2001. Both families had failed to raise the money to have the procedure carried out abroad. Both operations went smoothly and are the patients are now recovering at IHK.

The surgery has been carried out under the auspices of Hope Ward, funding for which has come from some fund-raising events, corporate sponsors and IHK itself.

The team leader for the project was Dr Moses Galukande, Surgeon and Director Medical Services – Education and Research, IHK. The cardiac team was led by Dr Clement Akomea Agyin, a consultant cardiac surgeon currently working in St Anthony’s Hospital London. Dr Clement is a British national of Ghanaian extraction, who is married to a Ugandan. The heart lung by-pass machine was operated by a perfusionist Mr. John Francis Nelson who accompanied Dr Clement. The rest of the team were from Uganda, they included Dr Tom Mwambu a cardiac surgeon from Mulago, Dr Stephen Tendo, Dr Joseph Ejoku and Dr Kephas Mijumbi - consultant anaethetists, Sister Maureen Twikirizi and her theatre nursing team, Dr Eduard Khahdazhapou and his ICU team and Ms Susan Elaborot and her team from IHK laboratory.

Dr Ian Clarke, Dr Moses Galukande and Dr Clement Agyin have been developing this project for the past eleven months. The project became feasible when Dr Clement obtained a heart - lung by-pass machine from St Anthony’s hospital. IHK procured the other necessary monitoring, anaesthetic, theatre, intensive care and laboratory equipment and sent a small team of theatre nurses to Mulago to gain experience in cardiac surgery.

IHK have been working steadily over the past number of years to reach the standards necessary to perform such high level surgery. During surgery the patient was constantly monitored by both invasive monitoring devices and external monitoring, for intra-arterial pressure, central venous pressure, ECG and BP, core body temperature, acid base balance, blood gases. During the procedure the blood is diverted from the heart through the heart lung by-pass machine, the heart is then paralyzed, opened and the hole in the heart repaired, as the blood is circulated through the rest of the body by the by-pass machine. At the end of the surgery the paralysis of the heart is reversed and the circulation is restored to the heart. After surgery the patient is closely monitored in Intensive Care Unit for several days, before being transferred back to the ward.

IHK together with Dr Clement Agyin and Mr. John Francis Nelson plan to carry out open heart surgery several times per year. The anticipated cost of each case is in the region of $6,000. IHK hopes to raise these funds through some donor organizations, fund raising events, contributions from patients and from well wishers. They hope to carry out a further seven cases in September of this year.