The last open heart surgery conducted in Zimbabwe was in
October 2018 and since then, patients have had to travel to India and other
countries for the procedure.
As the Second Republic has moved to improve healthcare
delivery for all, Government has committed to reviving the programme which will
see heart patients getting open heart surgeries locally instead of travelling
to other countries.
Specialist cardiovascular and thoracic surgeon Dr Simukayi
Machawira said the team was now in place and ready for the first surgery on
Thursday with all the consumables needed in place.
“We are preparing for resuming open heart surgeries and we
already have a lot of consumables, medications and we are checking the
machinery. At this stage we are screening the patients that are planned for
surgery and on Thursday we will be able to start our first case. The team is
ready to embark on this programme because this is something we have been
pushing for the past five years and we are looking forward to it,” he said.
Open heart surgery entails cutting open and performing
surgery on the muscles, valves or arteries of the heart to treat problems such
as heart failure, congenital heart defects, coronary artery disease, among
others.
According to Dr Machawira, it is difficult to operate on a
beating heart, hence a heart-lung bypass machine is connected to take over the
function of the heart and lungs to allow the surgeons to operate on the patient
in a more controlled environment.
He said at least 4 000 children that are born each year in
Zimbabwe need open heart surgery for them to be able to survive. However, many
will succumb to the natural disease progression if the disease is left
untreated.
“We also have the burden of rheumatic heart disease which
unfortunately is poorly documented. At the moment we have between 500 and 600
patients with rheumatic heart disease awaiting surgery and these are mainly
adult patients”.
While the programme will consider patients of all ages, Dr
Machawira said they would start with adults who are easier to manage and as
they build team confidence, move on to children and the more complicated cases.
“For a start, we are looking at one to two surgeries per
week until we have built a bigger team, because we really need a big team for
us to be able to do more cases. Ideally we should be able to do at least one
open heart surgery case a day during the working week. If we can do more, the
better but this all depends on the personnel as well as the equipment, so we
are still looking to the Ministry of Health for support in this programme,” he
said.
Depending on complexity of the case, most procedures can
last between three to four hours but some more complicated cases have been
known to go up to 16 or 18 hours.
“Our team for this programme is very large, at any one time
we are looking at between 20 to 30 people for us to have successful outcomes.
Bear in mind that there is complex machinery that is used and we have personnel
that prepares the patient before surgery, personnel that is involved in the
operating itself and this patient after surgery goes to the intensive care unit
where they are monitored 24 hours a day so they will need a lot of personnel to
take care of them,” said Dr Machawira.
The personnel needed includes anesthetists, cardiologists
and cardiothoracic surgeons. In nursing care, there are floor nurses who see
the patients as they come into the ward, then the theatre nurses take over
during the surgery after which the intensive care nurses take care of the
patients.
Other disciplines integral to performance of the surgery
include the laboratory, radiography, pharmacy and rehabilitation, among others.
Parirenyatwa remains the only hospital both in public and
private sector that is able to offer open heart surgeries in the country.
“But our wish is to see all the major cities being able to
do open heart surgeries, that way we can give meaningful service to the
population because as it is we are just doing the bare minimum that can be
done,” Dr Machawira said. Herald
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