FAQ's about CABG (Coronary Artery Bypass Grafting) done at Cebu Doctors' University Hospital

It is normal for patients to be apprehensive when they are about to undergo coronary artery bypass surgery. I consider this a normal human reaction which is very much understandable....after all who wouldn't be scared? Their precious lives are at stake. They ought to know more and their questions answered to alleviate their anxiety. For patients who have had surgery in our center and to those who have yet to undergo the procedure, I hope these FAQ's would help you better understand what this is all about.

1. What is the experience of CDUH/Cebu Cardiovascular Center with regard to open heart surgery.

Ans: The center formally opened its doors in November of 1997. Just like any new center, it has it's own share of ups and downs. Since inception until now, it has come a long way from being a start up, to becoming a major player with the most experience in heart surgery in the Visayas and Mindanao.

2. How many centers are doing cardiac surgery in Cebu City?

Ans: There are 3 centers doing heart surgery in Cebu City at the present time, Cebu Doctors' University Hospital, Chong Hua Heart Institute and Perpetual Succour Hospital.

3. Who are the surgeons involved in the different centers catering heart surgery in Cebu City?

Ans: First of all, I would like to let it be known that all our cardiac surgeons are experienced and well trained. The Chairman and Chief cardiac surgeon at CDUH is Dr. Philip Chua. He had his Cardiothoracic Surgery training in Texas Heart Institute under Dr. Denton Cooley. He visits Cebu City every other month.

Dr. Chua's partners at CDUH are Dr. Peter Yb. Mancao (incoming chair of the Dept. of Surgery CDUH) and Dr. Arnold Tan (Chairman, CV surgery at Chong Hua Heart Institute). Both are young, energetic and well trained CV surgeons from the Philippine Heart Center. Dr. Mancao did have a stint at Texas Heart Institute in the US as well. Both Drs. Mancao and Arnold Tan do heart surgery procedures at Chong Hua Heart Institute and Cebu Doctors' University Hospital (CDUH).

The surgeons from Perpetual Succour Hospital come from the Philippine Heart Center in Manila who comes to Cebu City whenever they have cases to do.

4. What kind of cardiac surgeries are done at CDUH?

Ans: Coronary bypass surgery and valve replacement procedures are the most commonly performed at our center, however, any surgical cardiac procedures can be done except heart transplant.

5. What is the success rate of cardiac surgery at CDUH?

Ans: This is a very complex issue to answer that deserves further explanation. Many times I encounter patients that would compare notes without realizing that each patient is unique and that no two patients are alike. Existing medical conditions play an important role in determining the outcome of such a complex procedure. For example, diabetic, poor ejection fraction (weak heart), smoker with COPD (Chronic Obstructive Lung Disease), female sex (women tend to have smaller heart arteries) are all predictors of adverse outcome. The risk of surgery is obviously not equal among the various patients hence, comparing one for the other must be weighed based on the presence or absence of existing comorbidities. Granting that all factors being equal, our outcome at CDUH is at par with the best there is.

6. What preparations are needed prior to cardiac surgery?

Ans: In our center just like anywhere else in Cebu City or the Philippines for that matter, walking blood donors need to be screened and prepared prior to the procedure. Usually, around 5-6 walking donors are needed to donate blood products in the perioperative period. The patients blood is thinned to prevent clotting during surgery so that when it is finished, the thinned blood must be reversed and normalize.

7. What is the cost of surgery in CDUH?

While cost is seldom an issue in western countries, it is one of the most important factor to consider in this part of the world because payment comes right out of the patients own pocket. Our cost is very competitive and because of the many variables in each patient, it is preferred that you discuss this issue with the cardiologist because he/she knows the patients medical condition more than anybody else.

8. Why does CABG cost vary a lot?

Ans: Certain procedures (not routinely done) maybe necessary before surgery i.e. insertion of intraaortic balloon pump and Swan Ganz catheter, to ensure safety and better hemodynamic support during surgery.

Some of the common post operative complications include, atrial fibrillation (irregular heart beat), infection, post pericardotomy syndrome, and bleeding that might require reoperation etc. etc.

Cost can vary not only among patients but also among the various institutions. If cost is of paramount importance, I suggest that you discuss this with your physician privately. In addition, I would advise that you ask around and inquire from patients or friends who have had surgery in the different institutions and ask the following questions: Overall cost of the procedure, length of hospital stay, any complications and their overall experience including level of satisfaction.

My last piece of advise is to go with your "gut feeling" and stay with the doctor/institution you feel you can trust and you feel you are most comfortable with.

9. What is the usual length of hospital stay after cardiac surgery?

Ans: Uncomplicated patients are generally discharged within 7 days. Sometimes patients stay longer for various reasons. Complications are very unpredictable at times so that cost estimates should be taken just as it is, "An estimate"!!

10. Why surgery should be done and how can we get additional information?

Ans: As a rule, we recommend surgery if the patient has multivessel coronary artery disease or if the left main coronary artery is severely diseased. Studies have shown that life is prolonged with surgical intervention in this select group of patients as compared medical therapy alone. For additional information email me at Edgar_Tan@yahoo.com or you can visit: http://www.cebudoctorsuniversity.edu/hospital/cardio/