Big strides in keeping little hearts alive
The Lady Ridgeway Hospital’s Paediatric Cardiothoracic Unit reaches the milestone of 1,307 surgeries of which 1,070 were ‘major’ in 2014. Kumudini Hettiarachchi reports
Adjacent rooms with muted instrumental music playing in the background cutting out the hustle and bustle of the cries of children and the sound of worried parents rushing about. Purposeful are the teams scrubbed up and green garbed in the two rooms, for in their hands they are holding two tiny hearts.
The hearts, one of a year-old baby and the other of a 10-day-old newborn, are undergoing major surgery in the Cardiothoracic Operating Theatres of the Lady Ridgeway Hospital (LRH) for Children, Colombo, under the skill and expertise of the teams headed by Consultant Cardiothoracic Surgeons, Dr. Mahendra Munasinghe and Dr. Kanchana Singappuli, respectively.
We see these heart operations on February 2 and the Paediatric Cardiothoracic Unit is pulsating with joy, for it has notched up a record 1,307 surgeries last year (2014) of which 1,070 were ‘major’ ones.
As the little hearts are made to stop beating, stilled and emptied to enable the surgical teams -- ably supported by the anaesthetist, perfusionist and nursing teams -- to perform complex surgery, the heart-lung machines (ventilators) take over the vital task of keeping the babies alive.
In wonderment, the Sunday Times team too, masked and gowned, looks on as Dr. Munasinghe’s ‘blue baby’ from Katugastota has three of the four major defects in a condition called Tetralogy of Fallot are corrected, with the fourth automatically righting itself.
Dr. Singappuli, meanwhile, who is dealing with a tinier baby-heart is attending to a different complex defect – the Transposition of the Great Arteries. (See graphic)
The Paediatric Cardiothoracic Unit has reached a major milestone, explains Dr. Munasinghe when the Sunday Times meets him a week later, only to find that the one-yearold has already left with his parents for their humble home in Katugastota.
The unit’s heart surgeries are performed by Cardiothoracic Surgeons Dr. Munasinghe, Dr. Singappuli, Dr. Y.K.M. Lahie and Dr. P. Ratnayake. Working in tandem with them are: Consultant Anaesthetists Dr. A. Perera, Dr. D. Jayawickrama and Dr. M.M. Premaratne along with Consultant Cardiologists Dr. Duminda Samarasinghe, Dr. S. Perera and Dr. R. Morawakkorala and junior doctors and Operating Theatre, Intensive Care Unit and ward nurses.
This unit opened in 2007 has been dealing with the heart problems of children and it was in 2014 that we jumped the 1,000-mark, points out Dr. Munasinghe, justifiably proud of this achievement.
Located on the ground floor of the LRH, in the Cardiothoracic Operating Theatres four to eight surgeries are performed every day. This unit has carried out the largest number of heart operations by a single unit in a year, he says.
It is linked to the Paediatric Cardiac Unit of the University of Arizona, Phoenix, America and the University of Southampton, United Kingdom, which in comparison carry out only about 300350 surgeries per year, it is learnt.
Each year, according to him, 2,500 children are born with congenital heart disease of which 1,400 require surgery. Jogging the memory of Sri Lankans, he recalls how before the unit was opened numerous were the photographs of pathetic children in the newspapers, with parents seeking help from the public for heart operations. But not any more. Before 2007, a few paediatric cardiac surgeries had been performed at the National Hospital, Colombo, and the Karapitiya Teaching Hospital, Galle, in the state sector and some private hospitals in Colombo. A few parents who could collect the money would take their children abroad.
“Unfortunately, 99% of the parents just could not find the money, amounting to anything between Rs. 600,000 and several million rupees. So the children were very sick and would be in and out of hospital. Many also died,” says Dr. Munasinghe with emotion.
Slowly but surely, the Paediatric Cardiothoracic Unit has been built up, performing surgeries free of charge. Many are those who have helped the unit along the way, individuals as well as companies and multinationals sending their ‘mite’ in the form of a few hundred to millions of rupees, he says.
“The Health Ministry has always responded whenever there was a need, but when there has been a sudden shortage of consumables, a donor has been found and the LRH has never-ever had to ask the parents of the sick children for a cent,” he says, adding that items such as soap, pampers and even bus-fare have also been provided to these families due to the generosity of donors.
He points out that sometimes people are quick to find fault and highlight a few shortcomings but the value of the free health system which provides preventive and curative care is hardly acknowledged. “Sri Lanka is probably one of the few countries in the world where heart surgery is performed free of charge.”