Abu Dhabi - The Division of Pediatric Cardiac Surgery at the Sheikh Khalifa Medical City (SKMC) managed by Cleveland Clinic has successfully performed 120 cardiac operations since the division opened in April 2007.
The postoperative pediatric cardiac services at SKMC are comprised of a 5-bed pediatric cardiac ICU, conjoined with a high dependency Unit (HDU) of 4 beds. Medical and nursing staff exploits the unit's full capacity. In addition to many emergent cases, patients scheduled for elective procedures are admitted for operations on a daily basis. The PCICU/HDU is run by its own dedicated medical and nursing staff on a 24/7 basis.
Dr. Norbert Augustin, Chair, Department of Cardiac Sciences, stated that "the Congenital Heart Surgical Program provides full cardiac services to children in the UAE. It helps us meet the needs of all those children affected in the Emirates rather than sending them abroad for treatment resulting in a reduction of stress for parents. It is an advanced pediatric cardiac care for the Emirate of Abu Dhabi and the UAE. Furthermore, SKMC is committed to continuous improvement of care to ultimately improve the health of the population of the UAE. "
He added "the goal of the department is to reduce the medical requirement for overseas travel, provide comparable cardiac services to all UAE residents and provide family members an opportunity to participate in the healing process before and after surgery. Health statistics show that the family is a vital part of the healing process and SKMC is happy to provide this service within the community".
He pointed out that "the Department of Cardiac Sciences at SKMC demonstrates the commitment of SEHA and SKMC to provide medical care that is advanced and meets internationally recognized standards of excellence".
Dr. Laszlo Kiraly, Division Head, Pediatric Cardiac Surgery, stated that "Until today, we have performed 120 operations for babies (including 33 neonates) and children with various congenital cardiac anomalies in the first ten months of the Pediatric Cardiac Program and we are extremely pleased to announce that the overwhelming majority of surgeries have been uneventfully accomplished with no major procedure-related complications. We strongly believe that our Pediatric Cardiac Program now fullfills the needs of a national program in this specialty. During the first year, the plan for the division was to establish our program and team, and to perform between 70-85 pediatric cardiac operations in 2007 which we have successfully achieved. Now, pediatric cardiac operations are performed at SKMC on a daily basis. However, for the year 2008, our aim is to reach a number between 150-200 cases. It is worth mentioning that with the opening of combined Pediatric Cardiac Intensive Care and High Dependency Unit, the length of stay in ICU and Hospital significantly decreased".
Dr. Kiraly avowed that "Our program could offer patients a unique solution for treatment, because a significant percentage of our little patients need immediate surgical attention; 23% of the surgeries were emergency within 24 hours and 30% were urgent needing surgery within one week. For these little patients it can be a question of life or death to have their life-saving operation locally performed as their transport abroad may not be feasible and holds extra risks. The most sophisticated and demanding procedures in heart surgery are emergency operations. In emergency situations, the whole team has to act fast, straight forward and with precision to save the patient's life. The SKMC team successfully managed quite a number of severe emergency cases, including complex neonatal repairs with a mortality rate matching international standards".
"One out of every four patients was a neonate and 78% of the patients' total number were less than 6 months old. Mean complexity of the operations was 9 on a scale ranging from 3 to 15. A significant number of our patients scored as highly complex (between 11-15) (e.g., transposition of the great arteries). In this condition, during an open-heart operation, the great arteries and the tiny coronary vessels (less than 1 mm in diameter) are transferred back to their normal location. This is a highly delicate and demanding surgery; this is why the results of this operation are used to index the quality of a pediatric cardiac center. We are very proud to announce that all of our six patients undergoing this operation survived with no complication," said Dr. Kiraly.
"As stated, majority of our patients presented with complex anomalies, still complete repair could be performed for most of them. In 66% of the operations, cardiopulmonary bypass (i.e., heart-lung machine) was used to overtake the circulation from the heart during surgery." He further added. "Our program initiated an important range of new services for children born with congenital heart anomalies that requests the best professionals from all involved disciplines. This is the essence of team-work. Our expertise includes a range of minimally invasive techniques used in cardiac surgery. For example, an atrial septal defect (which is a hole in the heart) is closed via a small skin incision on the right side of the chest (covered by the forearm of the patient). This minimal invasive technique avoids the widely used traditional approach through the sternal bone and satisfies patients, especially females, because of the outstanding cosmetic result".
"We believe that the Pediatric Cardiac Program established under the auspices of SEHA and Sheikh Khalifa Medical City has all the components needed to develop into a national and even regional center of excellence in the specialty", he stated. "It is quite challenging to do pediatric cardiac surgery in the UAE because of the high incidence of complex neonatal cases and the frequent occurrence of emergency operations. On the other hand, it is the most rewarding experience to see these little patients recover after surgery and go home with a 'repaired' heart. This is when their lives really begin."
From the Pediatrics Cardiology side, Dr Johannes Du Plessis, Consultant and Head of Pediatrics Cardiology, said "the Pediatrics Cardiac Surgery and Pediatric Cardiology divisions create a complete Pediatric Cardiac Team that manages the care of Pediatric patients at SKMC. The close collaboration is very vital between the surgeons and other members of the cardiollogy team to give an integrated service to our little children who deserve only the best. It is also worth to mention that our Cardiologists are available 24/7 for patients and doctors requiring pediatric cardiology advice."
The Department of Cardiac Sciences is a testament to the commitment of SKMC, Cleveland Clinic and SEHA to champion the on-going development of an accessible, comprehensive, sustainable, and fully integrated continuum of care for both adult and pediatric cardiac patients in the UAE.
SKMC Pediatric Cardiac Sciences Team & Services
The division of Pediatric Cardiac Surgery is headed by Dr. Laszlo Kiraly FETCS, Senior Consultant Pediatric Cardiac Surgeon. Also, Dr. Csaba Tamas, Consultant Pediatric Cardiac Surgeon joined the team. Both surgeons are from the National Heart Institute, Budapest, Hungary. Dr. Hansjorg Mossinger and Dr. Charles Ahene constitute the Pediatric Cardiac Anesthesia team. The surgeons are assisted by three theatre nurses and assistants who are all very experienced in pediatric cardiac surgery.
Congenital Cardiac Surgery provides immediate surgical treatment as:
- Primary repair for a wide variety of cardiac anomalies (e.g. defects/holes of the walls inside the heart, anomalies of the heart valves and great arteries) from the neonatal age through infancy and childhood up to adolescence
- A staged approach for those anomalies, where repair cannot be accomplished by a single operation (e.g. babies born with one half of their heart missing have to undergo more than one operation to ensure their survival)
- Pacemaker implantation even for very small neonates
- Treatment for congenital heart problems in the adult
Pediatric Cardiology which existed previously at SKMC is led by Dr. Johannes du Plessis a senior pediatric consultant cardiologist from South Africa with extensive experience in the specialty. He is ably assisted by a US-trained consultant pediatric cardiologist Dr Haitham Talo who is very experienced in echocardiography including fetal echocardiography and Dr. Stephen Shipton a pediatric cardiac consultant from South Africa who is in charge of the pediatric cardiac catheter laboratory. Dr. Shipton, has an extensive experience in interventional procedures for babies and children with cardiac disease obtained both in South Africa and the UK. The division of pediatric cardiovascular surgery and cardiology have at their disposal a complete complement of subspeciality pediatricians as warranted.
Pediatric Cardiology provides the following services:
- The whole spectrum of diagnostic procedures: from physical examination by specialists, echocardiography, electrocardiography, cardiac catetherization and cardiac computer tomography. The patient is thorougly worked up from first outpatient or ED visit till a comprehensive and holistic overview is developed, which includes extra cardiac anomalies. This enables the surgeon to perform the correct operation with a high degree of accuracy. Intraoperatively the pediatric cardiologists offer a Transesophageal echo service to perform immediate quality control on the surgery performed
- State-of-the-art interventional procedures in the new pediatric cardiac catheter laboratory will include balloon dilatation or stenting of obstructions, closure of anomalous communications, holes and defects with special devices.
- A 24/7 consultation service for patients and doctors requiring pediatric cardiology advice
- Preoperative and postoperative follow-up of CHS patients.
- A number of hybrid procedures have been performed where the invasive cardiologist and the surgeon operate simultaneously in theatre or the catheterisation laboratory. This is really cutting edge pediatric cardiology.
- Postoperatively pediatric cardiology is involved in assisting the critical care unit and the surgeons to monitor the patients for arrhythmias, structural and functional abnormalities of the heart and assist with the management in general.
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About SKMC
Sheikh Khalifa Medical City (SKMC), located in Abu Dhabi, UAE, operates under the management of Cleveland Clinic, named one of the top three hospitals in the USA by U.S. News and World Report . SKMC is owned and operated by SEHA, the Abu Dhabi Health Services Company, recently established to oversee operations of all public hospitals in the Emirate. It is the flagship institution for the public health system in Abu Dhabi and has several 'Centers of Excellence,' and aspires to practice contemporary medicine comparable to the best hospitals and medical centers in the world. SKMC provides comprehensive health care services in all of the disciplines relevant to the needs and priorities of the community to attain the highest levels of patient satisfaction.
SKMC consists of a 550-bed Acute Care Hospital, a 120-bed Behavior Sciences Pavilion and the 90-bed Abu Dhabi Rehabilitation Center, in addition to more than 12 specialized outpatient clinics and ten primary healthcare centers around the city of Abu Dhabi.
© Press Release 2008
