Every year approximately 35 children are born in Barbados with congenital heart disease and of that number about 15 will need surgery or interventional procedures.
To date there is no paediatric cardiac surgeon in the country and most children needing surgery are sent abroad, usually to the USA. Until the new cardiology wing opens in the Lions Eye Care Clinic, the Queen Elizabeth Hospital does not currently have an adequate cardiac catheterisation laboratory to accommodate these necessary cardiac interventions.
Paediatric cardiac surgical and interventional cases have been sent overseas, more recently to Jacksonville Florida where Glen Chuck Professor of Paediatric Cardiology and Chief of the Division of Paediatric Cardiology at the University of Florida, Dr. Jose A. Ettedgui arranges the cardiac surgical cases and performs the interventional procedures.
About 30 patients in the last three years have been referred to Jacksonville in what has been an expensive process averaging about BBD$66 000.00 per child, the majority of the cost is funded by government’s Medical Aid Scheme. The process is also time consuming and traumatic for the children. For the last few years Dr. Ettedgui has been coming to Barbados and conducting the paediatric cardiac interventional procedures at the Bracebridge Medical Centre where there is a cardiac catheterisation laboratory and recovery facilities.
During his two visits over the last few years Dr. Ettedgui assisted by Dr. Richard Ishmael has performed 11 interventional procedures on Barbadian children who were referred by the QEH and private physicians. Variety Clubs Caribbean funded Dr. Ettedgui’s and his cardiac nurse’s first trip to Barbados and covered the cost of the procedures for QEH patients, while private insurance covered the cost for private patients.
Variety Clubs still continues to make a contribution in funding the most recent trip but it is expected that the QEH Medical Aid Scheme will continue to cover the primary cost for the patients coming from the QEH.
Dr. Ishmael explained that the Paediatric Cardiac Interventional Procedures is where, “the heart is repaired without cutting into the heart through the chest wall but by repairing the defects from the outside using veins and arteries as conduits.”
Dr. Ettedgui who has been a paediatric cardiologist for more than two decades says it takes about an hour and a half to complete the procedure: “For example for a child with an Atrial Septal Defect which is a hole between the upper chambers of the heart, the child came in yesterday morning, had the procedure done and went home this morning and if there was school on Friday would be ready to go to school on Friday.
“As opposed to not only all the travel time and expense related to that of going to the US, but if it needs to be done surgically then the in hospital time recovery from surgery is at least five days, the amount of time before they can resume full physical activity is six weeks and so it is a huge difference,” he said.
Meanwhile, Chief Executive Officer of the QEH Dr Dexter James is extremely pleased with this development. He maintains that Caribbean islands are too small for an artificial divide between public and private care.
“Rather the public sector must find ways of embracing the private sector and enable capacity in country,” he said.
“This arrangement with the Bracebridge medical facility is yet another innovative approach for expanding access to care in a cost-effective way. Such partnerships with the private sector should be deepened and strengthened. The fact that such a very complex procedure can be done in Barbados speak to the capacity of local expertise and the system.”
Dr. Ishmael says this cutting edge method will be discussed in further detail at a Paediatric Cardiology Symposium in the QEH’s auditorium this morning, starting at 10 0’clock.
Dr. Ettedgui will discuss the latest techniques in Paediatric Interventional Cardiology and will be joined by Dr. Diane Alexander who is a paediatric cardiologist in Trinidad and she will discuss “Paediatric Cardiology in Trinidad”. Dr Ishmael will give an overview of Paediatric Cardiology in Barbados and the region.
All are invited.