An­giog­ra­phy for the masses

RISKSA Magazine - - Medical -

Late last year, Tyger­berg Hos­pi­tal’s di­vi­sion of car­di­ol­ogy unit un­veiled its new and ground-break­ing ra­dial an­giog­ra­phy ser­vice at the hos­pi­tal. This could make a sig­nif­i­cant im­pact on the cur­rent bot­tle­neck in the num­ber of pa­tients await­ing the pro­ce­dure. The car­di­ol­ogy di­vi­sion’s lat­est ad­di­tion has been hailed as the first of its kind on the African con­ti­nent and is al­ready mak­ing great strides in catch­ing up to the back­log of pa­tients in South Africa that re­quire this pro­ce­dure, as well as re­duc­ing costs to med­i­cal schemes. “The new fa­cil­ity will al­low us to per­form coro­nary an­giogra­phies and in­ter­ven­tions such as stent place­ment, sig­nif­i­cantly quicker and ul­ti­mately cheaper than we could be­fore. At present, the stan­dard way to per­form an an­giog­ra­phy is to ac­cess the ma­jor ar­ter­ies of the body through the groin of the pa­tient. This presents a num­ber of down­sides. Firstly, the pa­tient needs to be ad­mit­ted to hos­pi­tal overnight to re­cover from the pro­ce­dure. Se­condly, we are of­ten un­able to use this tech­nique on pa­tients that are deemed too frail,” ex­plains con­sult­ing car­di­ol­o­gist at Tyger­berg Hos­pi­tal, Dr Hell­muth We­ich. “In con­trast, dur­ing ra­dial an­giog­ra­phy we go in through the smaller veins in the pa­tient’s arm.

Do­minic Uys It is a pro­ce­dure that re­quires more spe­cialised train­ing on the part of the car­di­ol­o­gist, but it is con­sid­er­ably less in­va­sive and the pa­tient does not need to be ad­mit­ted to the hos­pi­tal ward for re­cov­ery. From that per­spec­tive it will clear up a lot of the bot­tle­necks that we have in the West­ern Cape at the mo­ment, and the cost for the pa­tient or the health­care fun­der will be sig­nif­i­cantly re­duced,” We­ich con­tin­ues. The state-of-the art fa­cil­ity op­er­ates un­der the di­rec­tive of the not-for-profit foun­da­tion Sun­heart and the di­vi­sion of car­di­ol­ogy, depart­ment of medicine, Stel­len­bosch Uni­ver­sity and Tyger­berg Hos­pi­tal. The multi-mil­lion rand in­vest­ment was made by key pri­vate and public part­ners, of which med­i­cal tech­nol­ogy provider, Medtronic, is the prin­ci­ple. “In South Africa, more than 50 000 pa­tients an­nu­ally re­quire ad­vanced car­diac care such as coro­nary an­giog­ra­phy. Yet, many don’t have ac­cess to th­ese pro­ce­dures and are, there­fore, de­nied po­ten­tially life-sav­ing treat­ments in­clud­ing coro­nary stents. The first ded­i­cated ra­dial suite at the di­vi­sion of car­di­ol­ogy will see a sig­nif­i­cant in­crease in the num­ber of pa­tients we are able to treat,” says Pro­fes­sor An­ton Doubell, head of the Car­di­ol­ogy Di­vi­sion and direc­tor of Sun­heart. Doubell de­scribed the pro­ce­dure as a ‘ busi­ness class coro­nary in­ter­ven­tion’, re­fer­ring to the cost re­duc­tion. The fa­cil­ity will ad­di­tion­ally be used to pro­vide train­ing for car­di­ol­o­gists through­out the coun­try in the ra­dial an­giog­ra­phy tech­nique. An ad­di­tional funded train­ing fel­low­ship and the ren­o­va­tion of the lec­ture room, re­sult­ing in an ul­tra-mod­ern lec­ture fa­cil­ity, has also boosted the teach­ing and train­ing ac­tiv­i­ties at the unit. The re­cent ex­pan­sions to the di­vi­sion of car­di­ol­ogy also in­cludes a new screen­ing fa­cil­ity for the di­ag­no­sis and study of rheumatic heart dis­ease in chil­dren. “We are busy con­duct­ing a study of 2 000 chil­dren in the re­gion in or­der to gather in­for­ma­tion on, and di­ag­nose, rheumatic heart dis­eases. The truth is that there ex­ists very lit­tle data on the con­di­tion in South Africa, and we are hop­ing to find out more on the preva­lence of the con­di­tion. It is a con­di­tion that mostly de­vel­ops in chil­dren, and it is of­ten ei­ther mis­di­ag­nosed or not caught at all. The only in­for­ma­tion of this kind that we have at present, dates back from the 1970s, and so far we are find­ing very dif­fer­ent re­sults from that, due in part, to the fact that we are us­ing much more ad­vanced and sen­si­tive equip­ment,” says con­sult­ing car­di­ol­o­gist Dr Philip Herbst.

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