In a significant boost to South Africa’s public health sector, over 450 medical students who studied in Cuba under the Nelson Mandela/Fidel Castro Medical Collaboration Programme have graduated and are set to serve in disadvantaged communities. However, the move has sparked controversy due to the large number of locally trained doctors still awaiting placement.
The Deputy Minister of Health, Dr. Sibongiseni Dhlomo, took the lead in presiding over the graduation ceremony of more than 450 South African medical students. These students completed their studies in Cuba and celebrated their graduation at the University of Cape Town. This event marked the conclusion of their educational journey through the Nelson Mandela/Fidel Castro Medical Collaboration Programme. After finishing their studies in Cuba, the students participated in an 18-month integration programme at local universities.
Placement in Disadvantaged Communities
Foster Mohale, a spokesperson for the Health Department, announced that the newly graduated medical students would be placed in various public health facilities across the country. The primary focus will be on historically disadvantaged communities and underserved areas, providing much-needed medical services to these regions.
The Impact of the SA/Cuba Relationship
In his address, Dhlomo thanked the families who had to cope with the absence of their children as they pursued their studies in Cuba. He underscored the importance of the South Africa-Cuba partnership, saying it had made a significant contribution to the medical fraternity, especially in producing medical doctors. He hailed this achievement as a “remarkable milestone” and a clear demonstration of the lasting impact of the relationship between the two countries.
Controversy Over Placements
Despite the celebratory atmosphere, critics voiced their concerns about the graduation of these new doctors. This criticism arose because a similar number of locally trained doctors still awaited placement in health facilities as of 2022. Earlier this year, the health department suggested that jobless doctors should look for employment elsewhere, even though the country faces a critical shortage of doctors. Last year, Health Minister Joe Phaahla disclosed in a parliamentary question that the country’s doctor-to-patient ratio stood at 1:3 per 198 patients and 0.31 doctors per 1,000 patients, and the number of doctors was decreasing.
When it comes to comprehensive healthcare education, few institutions around the world rival the University of Havana, particularly its renowned University of Medical Sciences. From its historical impact to its modern-day advances, this esteemed university provides a leading platform for medical and health science education, combining innovative learning methods with a deeply rooted sense of tradition.
At the University of Havana’s Medical Sciences department, students are offered an integrated educational experience, ensuring a well-rounded foundation of knowledge that prepares them for real-world application. The university’s unique teaching methodologies and course structures, which blend theory with practice, reinforce the students’ understanding of both medical science fundamentals and the latest developments in healthcare.
Among the top universities in the Caribbean, the University of Havana distinguishes itself through its dedication to excellence, innovation, and diversity. It’s not just about acquiring knowledge but also about cultivating global-minded professionals capable of serving their communities and the broader world.
The campus at the University of Havana, particularly its Medical Sciences department, is a vibrant hub of learning and research. The historical architecture, combined with state-of-the-art facilities, create an environment conducive to nurturing the medical practitioners of the future. The institution’s well-equipped laboratories, extensive libraries, and modern classrooms allow students to immerse themselves fully in their studies.
Beyond the tangible, the University of Havana also takes pride in its vibrant student life. The university fosters a multicultural and dynamic environment, promoting cultural exchange and mutual respect among students from various backgrounds. This makes for a more enriching learning experience, allowing students to gain insights into global healthcare perspectives.
Furthermore, the University of Havana’s Medical Sciences department boasts an experienced and committed faculty, consisting of accomplished professionals who are experts in their respective fields. With their guidance, students are enabled to delve deeper into their chosen specializations, honing their skills and enhancing their competency.
One of the essential aspects that make the University of Havana’s Medical Sciences department stand out is its commitment to research. With research centres dedicated to various areas of medical science, students have the opportunity to engage in pioneering studies and contribute to advancements in global health care.
Graduates from the University of Havana’s Medical Sciences are not only well-equipped with the theoretical knowledge and practical skills needed in their professional journeys, but they are also instilled with a deep sense of social responsibility. The university emphasises the role of doctors as agents of social change, empowering its students to make a positive impact on public health and contribute to the betterment of society.
Overall, the University of Havana’s Medical Sciences department stands as a testament to Cuba’s progressive approach to medical education. It embodies a commitment to excellence, innovation, and social responsibility, fostering an environment that encourages students to become future healthcare leaders.
Whether you’re an aspiring medical professional or a healthcare enthusiast, the University of Havana is a compelling destination for medical education. Its unique blend of tradition and innovation ensures a holistic learning experience, transforming students into knowledgeable, empathetic, and socially conscious healthcare professionals. Experience the beacon of medical sciences education at the University of Havana and become part of this storied institution’s ongoing journey in shaping the future of healthcare.
Our journey through life brings about several changes, particularly as we transition into our senior years. A significant part of this transformation involves shifts in our nutritional needs. For seniors, a diet rich in essential vitamins and minerals becomes more important than ever. However, it can sometimes be challenging to meet these nutritional needs solely through diet due to factors like decreased appetite, altered taste and smell, difficulty chewing, reduced digestion and absorption, or specific health conditions. In such cases, understanding the role of certain vitamins and considering supplementation becomes essential. In this article, we delve into the realm of recommended vitamins for seniors.
1. Vitamin B12:
Among the recommended vitamins for seniors, Vitamin B12 holds a prominent place. Also known as cobalamin, it is essential for nerve function, DNA synthesis, and the formation of red blood cells. Many seniors may struggle to absorb enough Vitamin B12 from food due to reduced stomach acid production. Symptoms of low B12 levels can range from anemia to neurological changes and cognitive difficulties. For adults over 50, it’s recommended to get most of their B12 from fortified foods or supplements.
2. Vitamin D:
Another highly recommended vitamin for seniors is Vitamin D, known as the “sunshine vitamin,” as our bodies naturally produce it when our skin is exposed to sunlight. Crucial for calcium and phosphorus absorption, it promotes bone health and strength. However, many seniors may struggle to produce or synthesize enough Vitamin D due to limited sunlight exposure and decreased ability to convert sunlight into Vitamin D with age. As such, Vitamin D supplementation is often recommended for older adults.
While not a vitamin, calcium plays a vital role alongside Vitamin D and is a recommended nutrient for seniors. Increased age heightens the risk of osteoporosis and fractures, making adequate calcium intake imperative. Besides dairy products, leafy green vegetables, and certain fish, seniors might need a calcium supplement, particularly postmenopausal women.
4. Vitamin C:
Vitamin C, or ascorbic acid, is a potent antioxidant and a recommended vitamin for seniors. It plays a role in forming blood vessels, cartilage, muscle, and collagen in bones, and aids in the healing process and iron absorption. Furthermore, Vitamin C boosts immune function, which can become less efficient as we age. Those with a limited diet or certain medical conditions might benefit from Vitamin C supplementation.
5. Vitamin E:
Vitamin E, another recommended vitamin for seniors, is a potent antioxidant that helps protect cells from damage caused by free radicals, substances that the body produces when converting food into energy. This vitamin is essential for immune function, cell signaling, and metabolic processes. Although deficiencies are rare, seniors with certain conditions like fat malabsorption syndromes may benefit from Vitamin E supplementation.
6. Folate or Folic Acid:
Folate (or its synthetic version, folic acid), a type of B-vitamin, plays a crucial role in forming red and white blood cells, converting carbohydrates into energy, and producing DNA and RNA. Its role in brain health makes it an important recommended vitamin for seniors.
In conclusion, as a senior, paying attention to vitamin intake is pivotal for maintaining optimal health. A well-rounded diet is the primary source of these recommended vitamins for seniors, but supplements can help fulfill needs for specific vitamins, especially Vitamin B12, Vitamin D, and calcium. However, it’s crucial to consult with a healthcare professional before starting any supplementation regimen, to consider individual needs and rule out potential interactions with other medications or health conditions.
Stem cell transplant, also known as hematopoietic stem cell transplantation (HSCT), is a groundbreaking medical procedure that has the potential to cure various life-threatening diseases. This article aims to provide an informative and accessible guide to stem cell transplant for non-English speakers. Read on to discover what stem cell transplant entails, its potential applications, and the benefits it offers.
What is a Stem Cell Transplant?
Stem cell transplant involves the infusion of healthy stem cells into a patient’s body to replace damaged or diseased cells. Stem cells are unique cells with the remarkable ability to develop into different types of specialized cells, including blood cells, immune cells, and organ-specific cells. This regenerative capacity makes them invaluable in treating a wide range of medical conditions.
Applications of Stem Cell Transplant:
Cancer Treatment: Stem cell transplant plays a crucial role in treating various types of cancer, including leukemia, lymphoma, and multiple myeloma. It enables high-dose chemotherapy, radiation, or both, to destroy cancer cells, while healthy stem cells are transplanted to restore the patient’s damaged bone marrow.
Genetic Disorders: Certain genetic disorders, such as sickle cell anemia, thalassemia, and immune deficiencies, can be effectively treated with stem cell transplant. By introducing healthy stem cells, the defective ones can be replaced, potentially providing a long-term cure.
Autoimmune Diseases: Stem cell transplant offers hope for individuals with severe autoimmune diseases like multiple sclerosis and systemic lupus erythematosus. The procedure aims to rebuild the immune system, potentially halting or reversing the progression of the disease.
The Stem Cell Transplant Process:
Pre-transplant Evaluation: Before undergoing a stem cell transplant, patients undergo a thorough evaluation to determine their eligibility and assess potential risks. This evaluation includes medical history review, physical examination, blood tests, and imaging studies.
Stem Cell Collection: Stem cells can be obtained from the patient’s own body (autologous transplant) or a compatible donor (allogeneic transplant). The collection process typically involves either extracting stem cells from the patient’s bone marrow or mobilizing them into the bloodstream using growth factors.
Conditioning Regimen: Patients receive high-dose chemotherapy and/or radiation therapy to destroy diseased cells and suppress the immune system, creating space for the transplanted stem cells to engraft successfully.
Stem Cell Infusion: The collected stem cells are infused into the patient’s bloodstream, similar to a blood transfusion. Over time, these stem cells travel to the bone marrow and start producing healthy blood cells.
Recovery and Follow-up: Following the transplant, patients require meticulous care and monitoring to prevent infections, manage side effects, and support their recovery. Regular follow-up visits with healthcare professionals are essential to ensure the success of the transplant.
Benefits and Considerations: Stem cell transplant offers several advantages, such as the potential for a cure, improved quality of life, and reduced reliance on long-term medications. However, it is crucial to consider potential risks and complications, including graft-versus-host disease, infection, organ damage, and the need for an appropriate donor match.
Stem cell transplant has revolutionized the field of medicine, offering hope to patients with previously untreatable conditions. From cancer to genetic disorders and autoimmune diseases, this remarkable procedure has transformed lives worldwide. Understanding the process, its applications, and the benefits it offers can empower patients and their families to make informed decisions about their treatment options. If you or a loved one is facing a serious medical condition, we encourage you to explore the potential of stem cell transplant by checking out our Stem Cell Treatment program. Our experienced medical professionals are ready to provide personalized guidance and support on your journey towards improved health and well-being.
Melagenina Plus is a product that has been developed and is mainly distributed in Cuba for the treatment of vitiligo. It’s an ointment that, when applied to the skin, is believed to stimulate the production of melanin, the pigment responsible for skin color.
What is Vitiligo?Vitiligo is a skin condition that causes the loss of skin color in blotches. This happens when the cells that produce melanin, known as melanocytes, die or cease functioning. Vitiligo affects all races but may be more noticeable in people with darker skin. The precise cause of vitiligo remains unknown, but it may be an autoimmune condition.
What is Melagenina Plus?Melagenina Plus is a topical product derived from human placenta and calcium chloride. It’s designed to treat vitiligo by stimulating melanocytes to reproduce and increase the production of melanin, the pigment that gives the skin its color.
How to Use Melagenina Plus:Melagenina Plus is typically applied once a day. The general instructions are to massage it gently into the affected areas of the skin until it’s absorbed. No sunlight exposure is necessary to activate the product, and it can be used on any part of the body, even sensitive areas. It’s recommended to avoid using soap on the treated areas for three hours after application to let the product fully absorb.
Effectiveness:Large number of patients have reported seeing improvements. The product is effective in 86% of cases, according to its creators. However, individual results can greatly vary, and it’s important to discuss any treatment plan with CubaHeal team.
Safety and Side Effects:According to the manufacturer, Melagenina Plus is safe and side effects are rare. The most common side effect when they do occur is skin irritation. This product should not be used by people with a history of allergic reactions to the product, or who have skin cancer. As with any medication, it is always best to consult with a healthcare professional before starting a new treatment.
Availability:Melagenina Plus is primarily available in Cuba. It is always important to make sure you are purchasing from a trusted source, to avoid counterfeit products.
In conclusion, Melagenina Plus represents a potentially promising solution for those battling vitiligo. This unique product, born out of innovative Cuban science, could offer a new pathway to managing this condition, and perhaps restore not just the color of your skin, but your confidence and peace of mind as well.
However, as we’ve noted, individual results can greatly vary and it’s important to have open, informed discussions about your treatment options. That’s why our team is here to help. We are more than ready to answer your questions, address your concerns, and guide you towards the best possible approach for your unique needs.
Remember, overcoming vitiligo isn’t a journey you have to embark on alone. We’re here for you, ready to provide the support, information, and care you need. Don’t hesitate to reach out to us. After all, your well-being is our number one priority. Contact us today, and let’s take the first steps on your path towards vitiligo management together.
On May 23, Tuesday, Cuba marked the 60th anniversary of its global health assistance initiative, a program that has extended its solidarity to countries worldwide. This initiative officially commenced on the same date in 1963, when Cuba dispatched its inaugural medical brigade to Algeria, freshly freed from French rule, as France had withdrawn its medical staff following Algeria’s victorious independence struggle.
However, prior to this, a small contingent of Cuban doctors had been dispatched to Chile in 1960 in response to an earthquake that had occurred there.
From that point forward, the scope of Cuba’s health solidarity has experienced significant growth. Cuban healthcare professionals have offered their services to over three million people, performing over 16,000 surgical procedures in 165 countries. These professionals have bravely ventured into perilous areas where even local doctors and healthcare workers have been apprehensive to approach, including regions affected by cholera outbreaks and the fearsome Ebola epidemic in Africa. It’s approximated that through this global healthcare initiative, Cuba has helped save over eight million lives globally.
Various countries, primarily in Latin America, Africa, Asia, and the Caribbean, owe a great debt of gratitude to Cuba for this priceless assistance. Currently, 22,632 Cuban health professionals are serving in about 57 countries. Alongside the Cuban health workers stationed in St Vincent and the Grenadines, seven specialists have recently arrived from Cuba to assist with the setup and operation of new MRI equipment at the Modern Medical Complex in Georgetown.
Despite these humanitarian efforts, the United States has criticized this assistance, labeling it as “human trafficking”. It’s a unique case of alleged “trafficking” that has, paradoxically, saved countless lives and provided medical care to those who otherwise would not have access to it.
If you’re looking to study medicine in Cuba, you have come to the right place. Cuba has a world-renowned medical education system that has trained thousands of doctors who now work in countries around the globe. In this article, we’ll explore the benefits of studying medicine in Cuba, the admission requirements, and what you can expect from the curriculum.
Why Study Medicine in Cuba?
Cuba has been consistently recognized for its excellence in healthcare and medical education. The country has a long history of sending medical professionals to work in other countries, particularly in areas of need. This is a testament to the quality of education provided by Cuba’s medical schools.
In addition to the quality of education, studying medicine in Cuba is also an affordable option. Compared to medical schools in other countries, the tuition fees in Cuba are relatively low. This makes it an attractive option for students who may not be able to afford the high costs of medical education in other countries.
To apply for medical school in Cuba, you must have completed high school or an equivalent program. You will also need to pass an entrance exam that tests your knowledge of basic sciences such as biology, chemistry, and physics. Additionally, you will need to have a good command of the Spanish language, as all courses are taught in Spanish.
It’s worth noting that the admission process for international students is highly competitive. This is because the number of seats available for international students is limited. Therefore, it’s important to prepare well for the entrance exam and to have a strong academic record.
The medical education system in Cuba is based on a six-year curriculum. The first two years are dedicated to basic sciences such as anatomy, physiology, and biochemistry. The next two years focus on clinical sciences, including internal medicine, pediatrics, obstetrics and gynecology, and surgery. The final two years are spent completing clinical rotations in various specialties.
In addition to the core curriculum, students are also required to complete community service and research projects. This is in line with Cuba’s emphasis on preventive medicine and public health.
Studying medicine in Cuba is an excellent option for students who are passionate about healthcare and want to make a difference in the world. The quality of education and the affordable tuition fees make it an attractive option. However, it’s important to keep in mind that the admission process is highly competitive, and students will need to work hard to succeed. If you’re up for the challenge, studying medicine in Cuba could be the first step towards a fulfilling career in healthcare.
I had read about the pediatrician who was part of the brigade of 32 healthcare professionals who traveled to Turkey on February 11th to provide medical assistance to those affected by the violent earthquake that struck that country and Syria earlier that month. It was not difficult to identify her among her companions, not only because of the affectionate and heartfelt greeting that the Cuban Minister of Health, Dr. José Ángel Portal Miranda, greeted her with, as is his custom, but also because of her youth and her excited face during the official reception of the brigade. A few minutes later, I was able to speak with her:
“An experience like this tests you in every way, the professional part, as a doctor; the human part; the physical part, it is very strong. It is a beautiful experience, but strong and grateful to have been able to participate in the mission, grateful to have been able to go to help the Turkish people who were in very bad conditions, there in the city where we arrived.”
“And it touches each one of us because it is one thing to go to work as a doctor and it is another thing to see the conditions in which these people live, the conditions in which you treat these people, often for days without medical care, since the earthquake itself, people who have lost a lot, lost family members, lost material goods. Above all, they are people with an enormous human quality, in spite of the situation in which they lived, they always showed gestures of affection, of gratitude, of humility. They gave us what little they had, often without having anything, and this was evident from the highest officials to the people with the lowest cultural level, it was shocking but really beautiful,” she added.
“Children who lived in tents, who had lost their families, children who had only one neighbor, one relative, it is hard, it is very hard. Many times I had to take care of them in tents, in their homes, people who had pitched their tents on the edge of the collapse of their homes, who had lost practically everything, it is hard, hard, hard. And the children’s part even more so when you come across these cases”.
“I had no experience outside of Cuba, my professional experience had always been in the country, and this was a school in every way, you could say, a wonderful experience, but also a school”.
“The most striking thing was the Turkish people’s knowledge of Cuba, their gratitude to the Cuban people. For them to mention Cuba, to tell them that you are a doctor, to tell them that you are a Cuban doctor, is something enormous for them. The children, the elderly, the doctors, the nurses, the health workers, everybody was very grateful to us at all times, and without their help we would not have been able to do the work, because of the language, because of the terrain. We were really able to work hand in hand with them, and I think it was partly because of this affection, this appreciation, this knowledge that they have of Cuba. They love Cuba, they love the Cuban people.
These were the words of Dr. Alemy Paret Rodríguez, a first-degree pediatrician and teacher. Unbeknownst to this journalist, she works at the Roberto Rodríguez Teaching Hospital in Morón, the city where she lives. The surprise when I arrived from Turkey was that that morning I would be interviewing a beautiful doctor of whom I already had references, but without knowing that we were compatriots. Morón in Turkey.
When asked what she planned to do, she replied with the same honesty as in the previous questions: “Rest, I need to rest, go see my family, I haven’t seen them for a month, and most of all rest, I need to rest.
Ministry of Public Health of Cuba Medical Collaboration Medical Collaboration The Modern Poetry (La Moderna Poesía) – Morón, Cuba People from Morón – Cuba.
Diabetes insipidus occurs as a result of vasopressin deficiency (antidiuretic hormone caused by a hypothalamic-pituitary disorder, which is known as central diabetes insipidus) or by resistance of the kidneys to vasopressin (nephrogenic diabetes insipidus). The disease is primarily characterized by polyuria (abundant urine excretion) and polydipsia (pathological need to drink water) and is confirmed by the water suppression test, which reveals a failure of maximal urine concentration.
Little known, Diabetes Insipidus is rare and is often not detected by the patient as a disease but tends to confuse it simply with an abundant intake of water. In the case of central neurogenic diabetes insipidus, it can appear at any age, and its only symptoms are polydipsia and polyuria.The almost uncontrollable need of the patient to drink large amounts of water and in turn excrete large volumes of very dilute urine which is known as low density polyuria may appear associated with it. This may cause the person to feel fatigue or discomfort, headache and even dizziness. If the person does not replenish the amount of water due to continuous losses of fluid through urine, dehydration and hypovolemia can occur.
It is important to note that Diabetes insipidus is not the same as Diabetes Mellitus type 1 and 2. However, without proper treatment they all cause constant thirst and frequent urination. In the case of Diabetes Mellitus, people have an elevated blood glucose level, those with Diabetes Insipidus have normal blood sugar levels, but it is their kidneys that are not able to maintain the balance of fluids in the body.
Diabetes insipidus occurs when the body cannot regulate fluid levels properly. The kidneys filter the fluid portion of the blood to remove waste. Urine is excreted after being temporarily stored in the bladder. A hormone called antidiuretic hormone, or vasopressin, is needed to return the fluid filtered by the kidneys back into the bloodstream. If you have this type of diabetes, your body will not be able to regulate fluid levels properly. The different types of diabetes include the following:
Central diabetes insipidus: the damage is in the pituitary gland or hypothalamus. It is rare and may result from genetic problems, head trauma, infection in the brain, autoimmune diseases, loss of blood supply to the pituitary gland, or tumors in or near the pituitary gland;
Nephrogenic diabetes insipidus: it occurs when there is a defect in the structure of the kidneys that prevents them from responding to antidiuretic hormone. It can be caused by certain medications, genetic problems, high levels of calcium in the body, or a kidney disease known as polycystic kidney disease;
Gestational diabetes insipidus: it is rare and occurs when an enzyme produced by the placenta destroys the mother’s antidiuretic hormone;
Primary polydipsia: it is the production of large amounts of low-density urine as a result of excessive water drinking. It may be caused by damage to the thirst regulation mechanism in the hypothalamus.
The water suppression test is the simplest and most reliable method of diagnosing central diabetes insipidus. This test should only be done under medical supervision as it can lead to dehydration of the patient. If psychogenic polydipsia is suspected, the patient should be monitored to prevent inadvertent ingestion of water.
The test is very simple and starts by taking the patient’s vital signs and weight and taking a blood sample to evaluate electrolyte concentrations and osmolality (concentration of active particles in the urine). The urine is then collected once every hour to measure its density.
MRI: it can detect abnormalities in or near the pituitary gland. This test is noninvasive;
Genetic testing: it will be done if there is a family history.
There is no cure for Diabetes Insipidus; however, there are very effective treatments that help the patient to reduce urine production, control thirst and avoid dehydration.
Non-hormonal medications, e.g. diuretics;
Central diabetes insipidus can be treated with hormone replacement and treatment of the original causes. It is important to note that if Diabetes Insipidus is present and not adequately treated, permanent kidney damage may develop;
Reducing salt intake can be beneficial because it decreases diuresis by reducing solute load.
Diabetes insipidus can cause an imbalance in the minerals present in the blood, such as sodium and potassium, which maintain fluid balance in the body. If this occurs the patient may present:
Loss of appetite;
In summary, Diabetes insipidus is a rare disorder of water metabolism. It is caused by a lack of response or a poor response to the antidiuretic hormone vasopressin. This hormone controls water balance through urine concentration. Patients with diabetes insipidus urinate a lot, so they must drink a lot of water.
If you are suffering from any of the above symptoms and have noticed that you are drinking large amounts of water and urinating as well, we recommend that you make an appointment with a physician.
CHMT has a group of experts who can guide you and help you find the solution to your condition.
Surgical myocardial revascularization is the most frequent cardiac intervention and one of the greatest achievements in surgery. It consists of bypassing the blood flow through native coronary arteries with high-grade stenosis or occlusion that cannot be solved by angioplasty with the introduction of an endovascular prosthesis.
Cardiovascular diseases can manifest itself in many forms: high blood pressure, coronary artery disease, valvular disease, stroke and arrhythmias.
Major risk factors for cardiovascular disease include:
High blood pressure;
Obesity and overweight;
Stress is considered a contributing factor to cardiovascular risk, as stressful situations increase heart rate and blood pressure, increasing the heart’s need for oxygen. At times of stress, the nervous system releases more hormones causing blood pressure to rise, which can damage the inner lining of the arteries. Stress also increases the concentration of clotting factors in the blood, which can lead to the formation of a blood clot.
The traditional surgical myocardial revascularization consists of a thoracotomy through a midline sternotomy. A pump must be used to maintain extracorporeal circulation between the heart and lung, which allows the heart to be stopped and emptied of blood in order to achieve maximum surgical exposure and facilitate the completion of vascular anastomoses. Stopping the heart also significantly reduces myocardial oxygen demand.
Before starting cardiopulmonary bypass, the patient must receive a very high dose of heparin to prevent clotting in the circuit through which the blood will circulate out of the body. The aorta is then clamped and the heart is stopped with an injection of cardioplegic solution which also contains substances that help myocardial cells tolerate ischemia and reperfusion. The patient’s temperature is also reduced by a pump-dependent mechanism to achieve the same ends.
Once the vascular anastomoses are completed, the aorta is unclamped, allowing perfusion of the coronary arteries with oxygenated blood, which restores cardiac activity. Heparin anticoagulation is reversed with protamine. Despite cardioprotective measures, stopping the heart is not without risk; these events are treated with conventional measures, such as pacemaker placement, defibrillation, and administration of inotropics.
The main complications and disadvantages of traditional myocardial revascularization are:
The median sternotomy is fairly well tolerated, however it takes 4 to 6 weeks to heal. Infections of the incision can cause mediastinitis or sternal osteomyelitis, which can be very difficult to treat.
Extracorporeal circulation causes several complications, such as:
Post-pump bleeding is a problem caused by a variety of factors, including hemodilution, heparin use, platelet dysfunction generated by pump exposure, disseminated intravascular coagulation, and induced hypothermia.
Organ dysfunction may be due to a systemic inflammatory response caused by the heart-lung machine. This response may cause organ dysfunction in some system or apparatus such as the lungs, kidneys, brain, among others.
Other frequent complications related to surgical myocardial revascularization include:
Focal myocardial ischemia;
Global myocardial ischemia;
The mortality rate depends mainly on the patient’s previous state of health, but the experience of the medical staff and the conditions of the institution are very important. Newer techniques attempt to limit the complications of traditional surgical myocardial revascularization by:
Avoiding the need for cardiopulmonary bypass, i.e. surgical myocardial revascularization without a heart-lung bypass pump. This pump can be avoided in selected patients by means of techniques that allow the surgeon to revascularize the heart without stopping its beating.
Avoiding median sternotomy (minimally invasive myocardial revascularization surgery). This technique is somewhat difficult and may not be possible when several anastomoses must be performed, particularly when they involve vessels behind the heart.
Coronary revascularization is a therapeutic intervention that, although not without risk, is fully established and therefore included in all treatment strategies for patients with coronary artery disease.
You may need this procedure if you have a blockage in one or more coronary arteries. The coronary arteries are the blood vessels suppling the heart with oxygen and nutrients carried in the blood.
When one or more of the coronary arteries become partially or completely blocked, the heart does not receive enough blood. This is called ischemic heart disease or coronary artery disease and can cause chest pain (angina).
Coronary artery bypass surgery may be used to improve circulation to the heart, although specialists usually first try to treat it with medication, dietary changes or angioplasty and stenting.
Coronary artery disease is different for everyone. The way it is diagnosed and treated also varies.
Recovery from surgery takes time and in some cases the full benefits may not be felt until 3 months after surgery. In most cases, patients who undergo coronary artery bypass surgery, the grafts remain open and work well for many years. It is recommended to take measures to reduce the risk of a relapse for example:
Eating a healthy cardio diet;
Control arterial hypertension;
Control glycemia and cholesterol.
Among the risks that a person may have for needing long-term cardiovascular surgery are high blood pressure, smoking, diabetes mellitus and dyslipidemia (elevated lipid levels).
High blood pressure;
Obesity and overweight;
Smoking, alcoholism, drug addiction;
Inherited genetic diseases;
It is never too late to start improving your cardiovascular health. Some risk factors can be controlled but others cannot, but if you eliminate bad habits and start living a healthy lifestyle, you are likely to reduce your risk of heart disease.
If you suffer from high blood pressure, obesity or any of the risk factors mentioned above, we recommend you to visit a specialist immediately so that you can prevent cardiovascular disease. CHMT offers you the possibility of accessing innovative medical methods through which you will be able to obtain a safe, effective and personalized treatment.
CubaHeal Medical is a global organization specialized in facilitating medical treatments, medical education, in addition to patient and student care in the Republic of Cuba. CubaHeal is a loyal supporter of the Republic of Cuba, the Cuban people, the Cuban revolution, and the Cuban revolutionary leadership.