Stenting is the future of Cardiology – Dr Gary Stephens
Stenting is the future of Cardiology and is therefore poised to replace, once possible, open-heart surgery. This is according to Dr Gary Stephens, Chief Executive Officer of the Caribbean Heart Institute (CHI), which is situated in the Georgetown Public Hospital compound.
Dr Stephens, who resides in the United States, is the lead Cardiac Surgeon at the facility. Over the years he has spearheaded a number of operations.
According to him, during an interview, about 50 Guyanese patients have undergone stenting procedures at the local heart institute.
A cardiac stent is a small tube that is used to widen arteries supplying the heart that have narrowed. Stents are often used in angioplasty, which is a procedure that improves blood flow through narrowed or blocked arteries.
They help prevent arteries from becoming narrowed or blocked again in the months or years after angioplasty. Stents are also placed in a weakened artery to improve blood flow and to help prevent the artery from bursting.
Dr Stephens explained that more patients are opting for stents over surgery. He added that stents available today are better medicated, last longer and most patients do well with them.
However, he pointed to the fact that there are some patients who cannot be stented. “More and more, a lot of the easier cardiac cases are stented but those that are considered severe don’t have any other option but to have open-heart surgery.”
Dr Stephens said that CHI has been securing the services of Interventional Cardiologists from the United States. He noted though that quite shortly CHI should have its own Interventional Cardiologist.
And this move could be very crucial, according to the Cardiac Surgeon, who disclosed that based on anecdotal evidence about 700 Guyanese would require open-heart surgery every year for coronary heart diseases. “If we are doing between 12 and 20 cases a year we are barely scratching the surface,” Dr Stephens admitted.
Additionally, he disclosed that a significant portion of the population in Guyana has valvular or rheumatic heart diseases, which are found mainly in the developing world.
According to Dr Stephens, many patients have for years been living with such diseases. “We are seeing these patients and they are very high risked for surgery but we have done a few here. I am sure if they had turned up in the US we probably would have told them no.”
Meanwhile, the installation of pacemakers continues to be one of the popular procedures undertaken at CHI.
“We have installed a lot,” said Dr Stephens, who revealed that the problem “we face in Guyana is that not all of the pacemaker companies, devices and programmers are compatible with each other.”
According to him, Guyanese have over the years gone around the world and have received pacemakers. There are today many persons who are possibly pacer dependent.
“We don’t have any way of checking them because maybe they got their pacemakers put in on some charity programme by a small pacemaker company,” Dr Stephens speculated. He related that pacemaker programmers from the three basic companies, Medtronics, St Jude’s and Boston Scientific, are easily accessible rather than those that are made by European companies.
“It is difficult for us to help patients with the European made pacemakers,” said Dr Stephens who related that “we don’t have any way of helping them right now until they start to have problems then we can change their devices.”
The majority of pacemakers utilised by CHI are from Medtronics which have about 65 percent of the world market, Dr Stephens disclosed.