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Uganda Heart Institute conducts first ever open heart surgery

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KAMPALA (DAILY MONITOR) – Doctors at Uganda Heart Institute at Mulago hospital have conducted the first-ever highly specialised open-heart surgery known as coronary artery bypass grafting surgery.
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart.

A team of 14 Ugandan medics on Monday conducted the surgery that lasted about 10 hours and involved harvesting veins and arteries from other parts of the body to repair affected blood vessels around the heart muscles.

Dr William Manyilirah, the lead consultant cardiothoracic surgeon, said the procedure was made possible after the heart institute acquired highly specialised equipment.

“The coronary artery bypass grafting is done in three stages; one involves transferring grafts from one part of the body. The grafts are veins that we get from the legs and arteries from behind the breastbone,” Dr Manyilirah explained in an interview with the Daily Monitor yesterday.

He said the successful surgery now means Ugandans will no longer have to travel abroad for triple coronary bypass.

Surgeons use CABG to treat people who have severe coronary heart disease (CHD). CHD is a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries.

Dr Manyilirah said the heart institute now has capacity to treat the heart condition at a cheaper cost of about Shs18m compared to about Shs300m in countries such as South Africa.

Relating the procedure to plumbing of water pipes, Dr Manyilirah said during the process, a patient’s heart is stopped to pave way for surgery.

He said during the procedure, the heart is replaced by the heart and lung machines which play both roles of the heart and lungs.

“After attaching the grafts on the affected heart arteries. The cardio-plegia solution is reduced to allow the heart to pump again by itself before weaning the patient off the lung-heart machine,” he said.

Dr Tom Mwambu, a senior consultant surgeon and the first assistant surgeon, said the procedure is used to bypass heart blood vessels that are blocked by heavy fat deposits using the grafts.

“We find this condition with people whose lifestyle is characterised by feeding on fats or foods with high cholesterol. These are people who don’t exercise to burn these fats,” Dr Mwambu said, adding that it also afflicts people with diabetes.

Unlike in the past, Dr Mwambu said the condition has been common among people with advanced age in the western world but there are emerging cases among young black people.

He said some patients present to hospital when they have collapsed, with left side chest pain, back and neck pain while others cannot lie flat.

“Some people come to hospital with heart failure symptoms like swelling of the feet,” Dr Mwambu said.
Dr Manyilirah said it takes about six hours after surgery for the patient to regain his or her full consciousness, and within two-three days, the patient is transferred from the intensive care unit to the admission ward before being discharged.

“We give the patient about eight to 12 weeks to come for review. This helps us to check whether the patient’s wounds have healed fully,” he said.

Dr Mwambu said some of the fat deposits near the brain, heart, and kidney might result in organ failure if not diagnosed and treated early.

He also asked the public to avoid getting predisposed to lifestyles of tobacco and alcohol abuse in order to avoid the condition.

Operating team

•Dr Tom Mwambu, Senior consultant surgeon and the first assistant surgeon

• Dr William Manyilirah, consultant and lead surgeon
• Dr Phillip Kabirigo, senior registrar and assistant surgeon
• Dr Joseph Ejoku, senior consultant and cardiac anaesthesiogist
• Dr Catherine Namutebi, cardiac anaesthesiologist
• Dr Juliet Nalwoga, anesthesiologist
• Dr Acan Josephine, cardiologist
• Dr Nampijja Dora, cardiologist
• Ms Muraa Pasculine, principal perfusionist
• Mr Carol Nakigozi, perfusionist
• Munduru Gertrude, principal cardiac theatre nursing officer
• Akello Pamela, theatre nursing officer
• Mutenyo Bernard, theatre nursing officer
• Mr David Kato, biomedical technician

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