New cardiac treatment protocols reduce deaths in Guyana - Cardiologist Dr. Mahendra Carpen

New cardiac treatment protocols reduce deaths in Guyana – Cardiologist Dr. Mahendra Carpen

Sep 20, 2018 News

New treatment protocols in cardiac care have been lending to a reduction in fatal outcomes.
Before implementing new treatment protocols, there was a 28 percent death rate for heart attack patients and an average of 8.8 days of hospital stay.
This is according to Interventional Cardiologist, Dr. Mahendra Carpen, who has been offering his expertise for a number of years here in Guyana.
He disclosed recently that after implementing the new protocols which include angiograms, angioplasty and stenting, there was a drop in death to 2.4 percent and hospital stay was reduced to 4.6 days.
“This represents a 10-fold reduction in death rates and halving of hospital stay. If one considers that it costs US$2000 – US$6000 per day to treat a hospitalized cardiac patient this translates to savings of $US$8000 – US$24000 per patient,” said Dr. Carpen.
For the first six months of this year alone, Dr. Carpen related that he and his team had approximately 8,500 patient visits for clinics, admissions and inpatient consultations over a one-year period at the two facilities he operate.
At these facilities, some 382 angiograms and 270 angioplasty with stenting, were conducted. But according to Dr. Carpen, “this represents a very small percentage of cardiac patients receiving invasive care.”
“There are many more patients who should have the benefit of an angiogram with proper revascularization [stent or bypass surgery] but for various reasons they are unable to get this level of care,” said Dr. Carpen.
However, he revealed that most of the complex and difficult cases are planned to occur when the visiting surgical team is on ground or arriving.
But according to the Interventional Cardiologist, angiogram and angioplasty with stenting are not the first choice of investigation and treatment.
Several non-invasive methods are available and utilized to manage patients before any invasive procedures are done. These include: echocardiograms, stress testing, ambulatory blood pressure monitoring, holter monitoring and sleep studies.
Dr. Carpen said too that clinical audits of outcomes are done mainly by the Libin Cardiovascular Institute, University of Calgary, which also assist in the development of treatment protocols, training, research and infrastructure development specific for Guyana needs and resources. He said too that real-time consultations are done with colleagues in Trinidad when necessary and pre-surgical assessments are done by a surgical team based in New York.
“My results are comparable to regional and international standards because I was properly trained by world class teachers, professors and doctors,” said Dr. Carpen whose disclosure was in response to concerns about his capabilities.
According to Dr. Carpen, “Since returning to Guyana, I was able to do the first implantation of an Intra-cardiac Defibrillator, first cardiac resynchronization device, first implantable loop recorder, first pacemaker lead extractions, first radio-frequency ablation for atrioventricular node re-entrant tachycardia, first ablation for Wolff-Parkinson-White Syndrome, first ablation for concealed retrograde accessory pathway.”
As the head of Cardiology, Dr. Carpen was instrumental in opening the first Cardiac Intensive Care Unit [ICU] at the Georgetown Public Hospital and also at the Cardiac ICU at the privately operated Woodlands Hospital.
He also established protocols for the treatment of heart attack [Acute coronary syndrome], heart failure and cardiac arrhythmias based on available resources. “I lead the initiative to ensure that every patient admitted to GPHC with a heart attack can have free angiogram and stenting without delay once they meet clinical criteria.
I have competent, young, dedicated and enthusiastic healthcare professionals who make up my teams, working with the singular goal of improving healthcare in Guyana,” said Dr. Carpen.

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