Latest update November 26th, 2024 1:00 AM
Bleeding during a local open heart surgery is a challenge – Dr Stephens
Though it may be deemed mere anecdotal evidence, Cardiac Surgeon, Dr Gary Stephens, is of the belief that Guyanese patients bleed a lot more during open heart surgery than those in the United States.
“This anecdotal evidence may just be in my head but this is my impression and it is certainly an area we are going to take a hard look at,” said an enthused Dr Stephens during a recent interview with this newspaper.
Dr Gary Stephens
The Cardiac Surgeon, who heads the Caribbean Heart Institute (CHI) located within the Georgetown Public Hospital Compound, related that there are instances where a single open heart patient can be transfused as much as seven or eight units of blood during an operation.
“We have always had anecdotal evidence. The guys in Barbados have always told me that Guyanese patients bleed a lot. I don’t know if it is our diet or something but it has certainly been our experience here that patients tend to bleed a lot more and I am not sure what the issue is here.”
He explained that since CHI started open heart operations locally conversations with officials from the Blood Bank have revealed the crucial need for blood during such operations.
According to Dr Stephens, a lot of blood and blood products are required during operations thus patients before they are operated on are expected to bring at least eight persons who could donate blood to offset the anticipated depletion.
“Patients are required to make some arrangements with the Blood Bank, independent of us, before any surgery is done. They have to get clearance from them (Blood Bank) first until we have enough blood available to us.”
In his quest to find a reason for the bleeding situation, Dr Stephens has been able to deduce that the medication that some patients use could be a contributory factor.
“You would tell them to stop it but they wouldn’t and they will come to you and say I have stopped it when they know that they used it until the day of surgery not realising that by holding back that little piece of information can cost them their lives if we can’t stop the bleeding.”
In order to overcome such predicaments, the Cardiac Surgeon related that CHI was forced to bring in patients ahead of their impending operations and physically take their medications away.
And though this is not the way that CHI had intended to operate, Dr Stephens noted that for every local circumstance a local solution will be designed even though it may be short term.
“This is what we have to do before any operation, they have to come and deposit their medication with us so we are assured that they stop it because with our limited supply of blood we can’t have a situation in which the patient is bleeding. The bypass machine itself causes bleeding so if a patient is already at risk for bleeding and they use some medication it creates a huge problem for us.”
Meanwhile, Dr Stephens disclosed that though follow-up care is essential for open heart patients it should not be a prolonged process. According to him open heart surgery, specifically from a surgical standpoint, does not require much follow up.
The New York based Cardiac Surgeon, disclosed that in the United States he sees patients once after they are operated on in order to make sure that they are surgically fine.
“If I see a patient more than once there must be some issue…I try to do the same thing here…However in Guyana I see patients a little bit more because once I am around they come anyway.”
According to Dr Stephens, most open heart surgery patients are usually followed by their internist or their cardiologists who are responsible for referring them for surgery in the first place and would know what to look for following the operation.
In addition to the prescribed use of medication, Dr Stephens noted that patients are also required to maintain a recommended diet to remain healthy.
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