Heart patient, 66, succumbs

Sep 28, 2009 News

By Sharmain Cornette

“There is no zero risk in heart surgery. Everybody who goes on the table runs a risk of dying from this procedure even though we think we may do our best.”

Cardiac surgeon, Dr Gary Stephens, made this comment after a 66-year-old open-heart surgery patient succumbed at the Caribbean Heart Institute (CHI) yesterday.

Dr Gary Stephens

The patient was among two others who were afforded open-heart operations at the weekend.

Reflecting on the operation during an interview yesterday, Dr Stephens related that although from all indications the patient had a heart attack before surgery there was hope that he would have been alright.

“We think he had a massive heart attack while he was in the operating room. We noticed that he had some substantial changes which included the fact that his blood pressure went down. So we knew even before we started to operate that something was wrong.”

According to the Cardiac Surgeon, the treatment for a massive heart attack is to ensure that blood is directed back to the heart quickly as possible before the heart muscles die.

And this procedure he noted was done with much urgency on Saturday, the day of the operation.

“We still went ahead and did the operation on him. It was very difficult to separate him from the by-pass machine…It took us maybe three or four hours before we finally separated him,” Dr Stephens recounted.

And there were moments of hope that the patient would have made a full recovery, but this was not to be.

Accepting their loss, some of the family members who were at the hospital yesterday thanked CHI staffers for their genuine support.

This newspaper was informed that in addition to having a heart condition, the patient was also a diabetic.

Dr Stephens divulged that so severe was the patient’s condition prior to the operation that he suffered chest pains on a daily basis.

“He was a diabetic…He had a triple vessel disease and he had to make the decision whether to live with the chest pains he got on a daily basis or have it fixed.”

According to the Cardiac Surgeon, patients generally have a clear understanding of the nature of what is done as well as the possible risks.

“Every patient that comes to surgery here gets a personal interview from me maybe two or three months before the surgery or depending on the acuteness of their situation. I would normally explain to them the risk and the benefits of the surgery.”

“Certainly everybody has a mortality risk based on their specific risk profile. Some people get five or 10 percent depending on the nature of their disease,” Dr Stephens asserted.

And just like all other operations that have been conducted at CHI, a review of the procedure that was utilised at the weekend will be reviewed.

The purpose, Dr Stephens noted, is to “ask the hard questions” to determine whether the right procedure was engaged in order to improve on future operations.

Age is no restriction

And there is no age limit when it comes to open-heart operations, the Cardiac Surgeon noted yesterday.

In addition to the patient that succumbed yesterday, there were two others aged 48 and 68 who underwent surgery. They were both up to yesterday recovering well at CHI.

According to Dr Stephens, “We do open-heart on anybody who, after we explained to them the risks and benefits, would want to proceed.”

He highlighted though that in the Guyana setting, most patients are relatively younger that those seen in the United States. Certainly in the Guyana setting a lot of our patients are much younger than we would see in North America.

Patients as old as 90 years old have been known to request open-heart surgery, he disclosed.

“People generally say that age is just a number. Some people are more active than others so we will not set age limits here (CHI). What we do here is to show our interest in the patients as individuals. Some patients are 67 but not all 67s are the same,” Dr Stephens noted.

More than 20 open-heart operations have been done at CHI since 2007 when the inaugural operation was conducted.

Dr Stephens, a New-York based Guyanese, is also Chief Executive Officer of CHI and Chief of Thoracic Surgery at a Brooklyn Hospital as well as a staff Attending Cardiac Surgeon at the Maimonides Medical Center in the United States.

As part of his commitment to the local heart institute, which represents a major government/private partnership effort, the Cardiac Surgeon travels to Guyana about four times a year to offer his skills.