THE DEPARTMENT OF CARDIAC SURGERY
Dr. Mansoor Hussain MBBS, FACC, FACS, Professor of Cardiac Surgery

Brief History and Introduction:

The department of cardiac surgery in Mayo Hospital and KEMU was started in the late nineteen-sixties with Dr. Aslam Cheema as its first head. It was the first department in any medical institution in the Punjab to perform open heart surgery. It was also the first to perform surgery for congenital heart disease, cardiac valve replacements and then coronary bypass operations.

For the last many years, the departments of cardiac surgery suffered a decline. However in 2005, after the medical college acquired the services of Syed Mansoor Hussain as professor and chief of cardiac surgery, the department has progressed rapidly. Dr. Syed Mansoor Hussain is a graduate of KEMC was a house officer in Cardiac Surgery at Mayo Hospital and then proceeded for further training in cardiac surgery to the US. He is a Fellow of the American College of Surgery (FACS) and a Fellow of the American College of Cardiology (FACC).

His areas of expertise include surgery for electrical problems of the heart, valve repairs, coronary revascularisation and support for the failing heart. After having been in practice in the US for more than two decades he returned to Pakistan. During his time in the US he was affiliated with Newark Beth Israel Medical Centre and was on the clinical faculty of the University of Medicine and Dentistry of New Jersey (UMDNJ). He is an author and co-author of many original publications in different aspect of cardiology and cardiac surgery.

During the year 2004, the total number of open heart operations performed at Mayo Hospital was only 76 while in 2005 the number went up to 245. In the first quarter of 2006, the number performed is 64 and it is expected the total number of cases for this year will exceed 300. Among other important changes that have taken place during the last year, new anaesthesia machines and monitors were acquired for the cardiac operation theatres. The post operative surgical ICU was also upgraded and now has some of the most advanced instrumentation available in any private or public cardiac centre in Lahore.

The latest innovations in cardiac surgery have also been introduced including off pump coronary bypass, valve repairs instead of valve replacement when needed, and bloodless cardiac surgery. A major change has been the introduction of free cardiac surgery. Over the last twelve months, this has been a source of great help for the indigent patients that seek medical help in the hospital. Further expansion of services is being planned.

DEPARTMENT OF CARDIAC SURGERY

Cardiac Surgery is located in the main block of Mayo Hospital and is also called the “thandee ward” or the cold ward since it was the first fully air conditioned ward in Mayo Hospital.

Faculty list:

Professor Syed Mansoor Hussain Professor and Chief MBBS, FACC, FACS
Dr. Hyder Zaman Associate Professor MBBS, FRCS, FCPS
Dr. Aftab Yunus Assistant Professor MBBS, FRCS
Dr. Zulfiqar Haider Assistant Professor (acting) MBBS, FRCS
Dr. Amir Iqbal Senior Registrar (acting) MBBS, FCPS

POST GRADUATE PROGRAMS:

1. Master of Surgery (MS). Anew research based curriculum for the Master of Surgery program is being developed. The purpose is to prepare a cadre of academic surgeons trained in clinical and research methodologies who can form the nucleus of future training programs.
2. Fellowship of the College of Physicians and Surgeons in Cardiac Surgery (FCPS). The department provides clinical attachment for physicians reading for the FCPS examinations.
UNDER GRADUATE PROGRAMS:
1. MBBS. The department provides clinical rotation for medical students as well as a series of didactic lectures.
2. BDS

ANCILLIARY STAFF:

The department also provides clinical rotations for students of the School of Physiotherapy and trains them in basic aspects of cardiac care and resuscitation.

RESEARCH PROJECTS:

Different clinical research projects are underway. These include:
1. Prevalence of Hepatitis B and C in the Cardiac Surgical population, analysis of risk in surgery and effect on long term survival. This is of great importance since many patients referred for cardiac surgery have viral markers for these forms of hepatitis. No information is available in the literature if this increases operative mortality and morbidity or has impact on long term survival especially in patients requiring life time anti-coagulation. This is an ongoing study and interim results will be publishes when an adequate cohort is available.

2. Prosthetic Aortic Valve Replacement, a comparison of pre operative gradients with immediate post operative gradients and delayed gradients across the valve. This is an echo based study and will attempt to correlate the clinical status of patients with valve gradients as measured by echo-cardiography in the post operative period.

3. Mitral Valve Repair in Patients with Mitral Regurgitation. Majority of patients requiring valve surgery are suffering from Rheumatic Heart Disease (RHD). The purpose of this study is to identify that subset of patients who develop mitral regurgitation for non RHD causes and are amenable to repair. It is important to identify this subset since repair avoids problems with long term anti-coagulation and improves survival.

4. Blood Less cardiac Surgery. Attempt is being made to develop methods to decrease the use of autologous blood consumption in cardiac surgery. Considering the present status of infective hepatitis transmitted by blood transfusions, and the difficulty in acquiring adequate supply of blood, this study will help in delineating those patients where surgery can be safely performed without the need for blood transfusions.
Funding is being sought to develop the infrastructure for creating an environment where clinical research can be carried out as a part of the normal training process. New technology like intra operative TEE, portable TTE, Cell savers is also being asked for. Furthermore, full time research staff will also be acquired. These plans are being developed at this time.
An attempt is being made to develop a first rate clinical department that provides appropriate care for the patients while at the same time presents an academic environment conducive to clinical research and in time basic research. Emphasis is going to be on preparing a new cadre of academic surgeons who can form the nucleus of future training and education in the filed of cardiac care.

CARDIAC SURGERY IN PROGRESS

CARDIAC ICU IN THE MAYO HOSPITAL