How Rwandan cardiothoracic surgeons carried out inaugral independent open-heart surgeries at King Faisal Hospital

Rwanda’s health sector is in a process of quick revolution due to multiple efforts put in place in a bid to increase the number of health experts, the Country has been short of. The country is currently boasting of her first cardiothoracic surgeon whose efforts to change the narrative is taking shape right from King Faisal Hospital in Kigali.

RBA’s Gloria Mutesi visited one of the heart touching surgeries of patients initially suffering from Rheumatic Heart Disease

29-year-old man identified as Celestin was in the past ridiculed by his peers as a weak man because of his inability to conduct normal tasks such as walking up a hill or carrying a jerry can. But Celestine's heart was failing.

But neither he or his family could at anyone point think that he had Rheumatic heart disease, a condition that made his heart pump poorly, that blood backed up in his veins bloating his liver and spleen filling his abdomen with fluid.

"After being misdiagnosed for so long at the community health centre, the father of three was transferred to King Faisal Hospital where Dr Gloria Mukeshimana, one of the five cardiologists, Rwanda has determined that he had a heart condition. He was fortunate enough to be admitted at around the time patients with Rheumatic Heart Disease were being screened for open-heart surgery. Dr Mukeshiman explains the criteria they used to select which patients would undergo open-heart surgery," Celestin said. 

DR Mukeshimana told RBA; "For the last twelve years, patients with RHD have had to wait for long periods of time for a team of visiting surgeons under the charity organization Team Heart from the United States to come and perform open-heart surgery," 

That is a thing for the past now because last year, Rwanda graduated its first cardiothoracic surgeon Dr Maurice Musoni who is currently performing open heart surgeries on eight patients at King Faisal Hospital. This is a milestone in Rwanda’s healthcare system and a pacesetter for the future of cardiac health in Rwanda as stated by Dr Edgar Kalimba

Dr Kalimba said; " Rheumatic Heart Disease is a heart condition in which heart valves have been damaged due to untreated or under-treated strep infections," 

There is an estimated 1000 patients known that suffer from RHD all waiting for a heart surgery, some of which end up losing their lives in the process. A team of surgeons, perfusionists, anesthésistes, and nurses this week gathered at King Faisal Hospital to conduct open-heart surgery. Moments before the surgery, the patient is injected with an anesthésique drug to induce sleep and make them insensitive to pain.

The théâtre has an x-ray viewer and a tv monitor that surgeons use to follow the patient’s vitals. There is also a heart-lung machine that will later help the patient pump blood when his heart is stopped to fix the valves. The surgeons use a sternal retractor to hold the dissected part of the chest apart to get access to the heart.

The cover to the heart is cut open, and a drug that prevents blood clotting is administered. The tubes from the heart-lung machine are connected to the heart’s major arteries. At this moment, the heart is still beating normally, a cardiac arrest drug is injected in the patient to stop the heart from beating.

At this point, the heart-lung machine is helping the patient pump blood as the surgeons embark on the valve repair which takes between four to ten hours depending on the damage of the heart.

Meanwhile 19 year-old Emmanuel Niyobuhungiro that was operated on Tuesday this week is recovering in the Intensive Care Unit.

Dr Erneste Simpunga, a survivor of Rheumatic Heart Disease completed his medical school last year and hopes to be a cardiologist to help diagnose and treat people with RHD.

As he kick starts his career in cardiothoracic surgery, Dr Maurice Musoni sees a bright future in terms of patients not having to wait longer to get treatment.

King Faisal is looking to set up a cardiac centre to reduce the burden of cardiac diseases in the country and in a bid to build capacity, Team Heart has planned four mentorship trips to Rwanda this year to prepare the Rwandan team to be confident enough to do the surgeries on their own. 

Dr François Uwikindi, the division manager of noncommunicable diseases and heart diseases at the Rwanda Biomedical Centre explains the plans the government has to treat heart patients daily without having to travel abroad for intervention.

During the 71st World Health Assembly in Geneva, a resolution for a comprehensive approach to prevention and control of Rheumatic Heart Disease was adopted. Rheumatic Heart Disease affects about 30 million people globally and causes 305,000 deaths annually.