Good news to heart patients

Heart patients can have a safer heart surgery at IJM without going overseas.

IJN can now replace heart valves without open heart surgery

KUALA LUMPUR: The National Heart Institute (IJN) achieved another milestone by performing the first heart valve implant in Asia without the need for open surgery.

Known as transcathether aortic valve implantation (Tavi), the procedure allowed problematic valves in the aorta to be replaced with an articifial one by using a tube that is 6mm in diametre known as a cathether.

The tube is inserted either at the thigh area or below the left collar bone and then slid through arteries to the heart.

And the procedures has a 99% success rate.

“Patients, who have gone through Tavi, will be able to move around on the third day after the implant but they would be required to lie down during the first 24 hours,” said IJN medical director Datuk Seri Dr Robaayah Zambahari.

She was speaking to a press conference to announce the achievement at IJN here Friday.

The procedure, which uses a device called CoreValve, causes less trauma to body tissues and enables a faster recovery compared to the conventional open heart surgery as only incisions are made at certain areas to insert the tube.

Dr Robaayah was part of the team of IJN consultants that performed the procedure on the first patient, a 73-year-old man who suffered from severe narrowing of heart valves and a second patient, a 77-year-old man on November 25.

The third patient was National Laureate Datuk Shahnon Ahmad, 76 who was treated the next day.

The team included cardiologists Datuk Dr Rosli Mohd Ali, Dr Shaiful Azmi and cardiothoracic surgeons Datuk Dr Mohd Azhari Yakub, Dr Jeswant Dillon as well as anaesthesiologists Datuk Dr Mohamed Hassan Ariff and Dr Sharifah Suraya.

The procedure was assisted by Dr Ganesh Manoharan, a consultant interventional cardiologist from Ireland, who will also overlook the operations of the next 12 to 15 patients.

“The 12 to 15 patients are currently on the waiting list to be certified by IJN and the costs of their operation will be borne by IJN.

“After that, patients need to know that the CoreValve device will be RM112,000 while another RM10,000 will be needed for other operation costs,” she said, adding that she hoped the Health Ministry would offer support and subsidise the procedures for the public in future.

Dr Robaayah said there has yet to be any case of a patient’s body rejecting the artificial valve made out of a type of metal called Nitinol.

“The procedure takes an average time of 45 minutes to one and a half hours. We took about two and a half hours for the first patient because we were still learning about the procedure and wanted to be careful,” she said, adding that the method was only performed on high-risk patients such as the elderly, so far.

Dr Ganesh said local anaesthesia was used on the patients so that they remained awake during the procedure but did not feel any pain.

“It is not surprising to see patients smiling as we conduct the procedure on them,” he said.

“About 50 centres worldwide are applying this technology but it is more suitable for this region since Asian blood vessels are generally smaller,” Dr Ganesh added.

http://thestar.com.my/news/story.asp?file=/2009/12/4/nation/20091204162432&sec=nation

Being a "vegetable" for 23 years

Imagine if you were stuck in your body for 23 years being completely aware of your surroundings but not able to voice out your opinion.

Brain scan finds man was not in a coma--23 years later

Rom Houben has been trapped in a series of worst nightmares, including trying for 23 years to alert those around him that he was not in a coma. A new report suggests he's not alone in his experience.

Neurologist Steven Laureys used state-of-the-art brain scanning techniques to study Houben's cerebral cortex.

(Credit: Universite de Liege)

In 1983, Belgian engineering student and martial arts enthusiast Houben, then 20, was in a car accident that was thought to have left him in a vegetative state. Doctors relied on the widely-used Glasgow Coma Scale, assessing his eyes, verbal, and motor responses. What they failed to notice was that Houben was actually conscious--but completely paralyzed.

"I screamed, but there was no one to hear," he says in an interview with the German magazine Der Spiegel. Three years ago, neurologist Steven Laureys used modern scanning techniques to discover that Houben's cerebral cortex was, in fact, functioning. (The doctor has only just now made Houben's story public.)

Houben, who communicates via a computer with a special keyboard activated with the slightest movement of his right hand, is now 46. He has spent more than half his life trapped in his own body, and says he only survived this excruciating existence by dreaming himself away. In the interview, this is what he typed:

I am called Rom. I am not dead. The nurses came, they patted me, they sometimes took my hand, and I heard them say "no hope." I meditated, I dreamed my life away--it was all I could do. I don't want to blame anyone--it wouldn't do any good. But I owe my life to my family. Everyone else gave up.

I studied what happened around me as if it were a tiny piece of world drama, the bizarre peculiarities of the other patients in the common room, the entry of the doctors into my room, the gossip of the nurses who were not embarrassed to speak about their boyfriends in front of "the extinct one." That made me an expert on relationships.

According to Laureys, Houben's case may be far more common than we'd like to think. The doctor, who leads the Coma Science Group and Department of Neurology at Liege University Hospital, says that while Houben's doctors were "not good," he's not sure better ones using this same coma scale would have detected brain activity either:

In Germany alone each year some 100,000 people suffer from severe traumatic brain injury. About 20,000 are followed by a coma of three weeks or longer. Some of them die, others regain health. But an estimated 3,000 to 5,000 people a year remain trapped in an intermediate stage--they go on living without ever coming back again.

In his paper, Laureys writes that in about 40 percent of "vegetative state" cases he has analyzed, current brain scanning techniques reveal signs of varying levels of consciousness. A case is being made, it seems, to stop relying on the Glasgow Coma Scale and start looking more closely at brain scanning images.

Source:http://news.cnet.com/8301-27083_3-10403861-247.html

Medical Secrets on Facebook

It seems that medical students also cannot keep secrets.

"Having trouble remembering your medical history? Try Facebook. Some 13 per cent of US medical schools have reported that their students have leaked confidential information about patients via blogs or social networking websites.

The students didn't name names, but did provide enough personal information, such as the medical condition involved and hospital, for patients or their families to recognise who is being described. The information was provided by medical school administrators as part of a survey into students' behaviour online."

Full Article:

http://www.newscientist.com/article/dn17828-for-medical-secrets-try-facebook.html