Wednesday, March 01, 2006

Angioplasty in Malaysia part 2

Part 1 of the history of angioplasty in Malaysia can be found here.

We began making arrangements in January 1988, to attend the Angioplasty Live Demo in the San Francisco Heart Institute targetting April 1988. Being in private practice meant I could pay but the two consultants in public service would require some sponsorship. Thus we set out to raise the required funds.

One of the pre-requisites was experience in coronary angiogram, which we had by the boatload. Fortuantely the San Francisco Heart Institute was close to the former USCI Bards (interventional catheter company). USCI Bards was very understanding. They could see the need to bring angioplasty to Malaysia, so they agreed to sponsor one consultant and help us make the necessary arrangements. The other consultant was sponsored by Cordis Niche (now defunct). These two companies should be acknowledged for their role in bringing angioplasty to Malaysia which has thus far remained unrecognised. In a sense let this be a record of our gratitutde.

The meeting in San Francisco Heart Institute was good and well conducted. We saw what could be done to help our patients and knew that we could do it with proper training. At the end of the meeting, there was a gala evening get-together of a social nature.

We had decided by then that we should invite one of the senior member of the meeting faculty to Malaysia for a few objectives: to do some cases with us, to give us some hands on experience, and also to kick start the angioplasty program in Malaysia. At the gala evening, we met Dr David Clark, a very friendly trainer at the course. We approached him to inquire if he would be interested in helping us in Malaysia. The proposition was that he would spend two weeks in Kuala Lumpur to do cases with us in two public hospitals and one private center. Dr Clark very kindly agreed that two weeks would be sufficient, if he could find another angioplasty expert to accompany him so that they could do more cases with us, separately in two teams.

On our end there had to be about 10-15 cases lined up in each center. Upon our return, we began to make arrangements and selected the centers as GHKL, the University Hospital and the Subang Jaya Medical Center. All these centers had active open heart surgery programs capable of doing emergency CABG. We had to obtain the necessary certifications and approvals plus work out the cost and and consent.

Dr Clark had chosen Dr Tim Fischell to accompany him, and even offered to bring along Dr Norman Shumway. Let us take a moments pause to remember Dr Shumway who performed the first heart transplant in the US and did a lot of ground breaking work. He passed away recently (February 10th 2006) after living 83 years and one day.

We assured Dr Clark that there were cardiac surgeons in KL who could standby for us. In the meantime, we were collecting cases, who were symptomatic with positive stress ECG. Coronary angiograms were performed to make sure that they were suitable for angioplasty. We chose mainly single vessel disease cases although there were some double vessel disease patients too. Then we threw in some tough cases to spice up the mix. The patients were all informed that we were doing angioplasty for the first time in Malaysia with the help of American experts. There were to be no consultation charges but the patient had to pay for the consumables used, and a discounted hospital rate. The date was set for October 1988.

All was now ready. The stage was set for Malaysian people to benefit from angioplasty.

No comments: