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Open heart surgery performed at Province Specialist Hospital, the first outside KBTH

BY: Doreen Andoh
Prof. Frimpong-Boateng (in the kente head covering) working on the patient heart while other members of the team played other roles.
Prof. Frimpong-Boateng (in the kente head covering) working on the patient heart while other members of the team played other roles.

For the first time in Ghana, an open heart surgery has been conducted successfully outside of the National Cardiothoracic Centre of the Korle Bu Teaching Hospital (KBTH) in Accra.

The operation conducted at the Province Specialist Hospital in Accra is known as a mitral valve replacement surgery and was done for a 61-year-old man to save his life.

It was conducted by a 15-member medical team, including three heart surgeons, and led by the Minister of Environment, Science Technology and Innovation, Professor Kwabena Frimpong-Boateng, who has been celebrated worldwide as a heart surgeon.

The other heart surgeons were Prof. Martin Tamatey and Dr Kofi Gyan Baffoe.

Prof. Frimpong-Boateng is also well known for facilitating the setting up of the Cardiothoracic Centre of KBTH in 1992 when he was the only Ghanaian heart surgeon at the time.

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Over the years, the National Cardiothoracic Centre of KBTH has been the only well-equipped centre capable of providing specialised open heart surgeries in the country.

The reporter of the Daily Graphic was given the rare opportunity to witness the operation which lasted about four hours.

Mitral valve replacement

Mitral valve replacement requires the removal of a malfunctioning mitral valve and replacing it with an artificial valve.

The mitral valve is one of the four valves in the heart that facilitates the flow of blood to the heart and to the entire body.

Blood flows from the lungs and enters a pumping chamber of the heart called the left atrium. The blood then flows into the final pumping chamber of the heart, the left ventricle.

The mitral valve is located between these two chambers. It ensures that the blood keeps moving forward through the heart.

However, if it is damaged or impaired, it is unable to perform its functions properly, resulting in mitral valve incompetence disease.

If the impaired mitral valve is not treated, it could lead to complications such as heart failure.

A general symptom of this condition is palpitations, shortness of breath and general fatigue.

Observations

The Daily Graphic observed that the process officially started around 8:30 a.m. and ended at 11:57.

It was performed under general anaesthesia. An incision-deep cut was made through the chest and breastbone and the cut was then spread open to expose the heart.

The heart, after it was exposed, was made to cool down to stabilise it.

Then, the functions of the heart and lungs were transferred to the lung and heart bypass machine to enable the heart to be shut down for the surgery.

All that while, the patient had been placed under strict monitoring on computers to keep his clinical measurements such as pulse rate, respiration rate and blood pressure within range.

Small incisions were made in the heart to access the valve, which was removed and replaced with the prosthetic heart valve-- the artificial one.

After the replacement, the body temperature was returned to normal and patient was gradually weaned off the bypass machine, as the heart resumed its function, pumping on it again.

The breastbone was closed with special wires to keep it stable during the healing process. The tissue and skin incisions were then closed too.

The patient was prepared for the intensive care unit, where the Daily Graphic was told he would be monitored for at least 48 hours.

After the medical team had satisfied itself that everything was okay then the patient would be moved to the recovery ward for not less than 10 days before being discharged to continue the recovery process at home.

It was a very heart-throbbing process to behold, watching medical drills and knives, among other instruments, used to make various cuts, but it was very relieving to observe that after the surgery, everything went well.

One thing that struck the Daily Graphic was that although the members of the team were so focused, they shared some breathtaking hearty moments and encouraged one another.

The fact that the team also ensured that they announced every action before taking it and the constant appreciation of one another’s role, among others, made the process a more relaxed one.

Support

Speaking to the Daily Graphic after the surgery, Prof. Frimpong-Boateng said he owned the Province Specialist Hospital and had plans of setting up similar world-class heart theatres equipped with machines to support healthcare delivery.

He was quick to add that he was setting up the heart centres with the best equipment to support national efforts at improving medical services and to help the national medical tourism vision.

He said the international standard was that for every 200,000 people, there should be one heart centre to serve their needs and ,therefore, ideally, Ghana should have about 15 of such centres.

However, he said, currently there was only one public centre at Korle Bu Teaching Hospital, serving the needs of about 30 million people.

He said the inadequate centres vis a vis the population did not make room for efficiency, easy access and other requirements of quality healthcare delivery.

Collaboration

Prof. Frimpong-Boateng said he had plans to facilitate collaboration with any hospital that was to set up a heart centre, as well as the Korle Bu Teaching Hospital to provide quality heart services to many people, who would have had to travel out for those services.

He said he was ready to offer his support wherever it would be required locally at his free time.

He said he had trained about a 50 heart surgeons from Ghana, Nigeria, Europe, Togo, Ethiopia, among other countries, adding that he would continue to do that because it brought him satisfaction that one day if he was no more, he would have passed on his knowledge and expertise on to future generations.

He said today, it was fulfilling for him to watch some of the people he had trained play major roles in the first surgical process outside of Korle Bu.

“These guys are very competent, and they could have done it on their own, but being the first out of Korle Bu and in my hospital, I thought I should lead the team as a motivation and take full responsibility of the patient.

But trust me, they can do this without me,” he said.