The Cath Lab of Ayder Referral Hospital Mekelle

The second interventional cardiology workshop on congenital heart defects in Mekelle - Ethiopia had been held  in Mekelle - Ethiopia from October 29th to Nov. 1st 2018, organized by the German NGO Etiopia-Witten association.

This time the focus was on both, the balloon dilatation of pulmonary valve stenosis as well as closure of the patent ductus arteriosus (PDA*). It included again simulator training on a heart model and hands on work treating patients.

The workshop took place in the catheterization laboratory of the Department of Cardiology of Ayder Referral Hospital of Mekelle University. It was conducted by the pediatric interventional cardiologist Prof. Dr. Nikolaus Haas, Director of Department of Pediatric Cardiology and Pediatric Intensive Care Medical Hospital of the University of Munich Germany. Five patient had been successfully treated.

Two simulator models have been in use. They are 3-D models of the heart from silicone, printed by 3-D-Printer using a 3-D data set from adult human Cardiac CT. A stenotic pulmonary valve or a wide open ductus arteriosus was added. The models were developed by medical students of Munich University Cand. med. Alisa Thierij and Cand. med. Barbara Sophie Brunner under supervision from Prof. Nikolaus Haas.

The Ethiopian cardiologists Abraha Hailu Weldegerima MD, Hagazi Tesfay Haddush MD, the pediatrician Marta Yemane MD from Ayder Hospital Mekelle and the pediatric cardiologist Temesgen Tsega MD from St. Pauls Hospital Addis Abeba have trained by using the heart models before starting patient treatment.
Beside the extensive training on the simulator, for the fist time in Ayder Hospital three patients with pulmonary stenosis had been treated by balloon dilatation successfully. This in close cooperation with Prof. Haas and the Ethiopian interventionists. Because of the experience gained during the first workshop, the Ethiopian crew was able to perform two procedures to close the PDA independently and successfully.

The size of the PDA in One of the three scheduled patient was much too wide for the available closure devices. This patient has to be send for surgery.

Over all again this workshop was a great success for all. The heart models performed well and the cardiologists in the Ayder cath lab are now confident to offer soon these types of treatment to their patients.

The success of this workshop again was only possible thanks to the great and reliable support of the cath lab nurse team and the nurse anesthetist Alem Gebreyesus.

A third workshop is planned for the near future.

The financing of the expensive single use materials and the closure devices was taken over by Mekelle University.

* A PDA is characterized by the persistence of a normal fetal connection between the aorta and the pulmonary artery through which erroneously oxygenated (red) blood circulates  through the lungs. A big PDA can cause serious negative consequences. In addition to early lung failure, severe, permanent damage to the lung tissue can develop. Also bacterial infections of the heart are possible.

During a five-day workshop from July 23 to July 27, 2018 at the Ayder Referral Hospital of Mekelle University in Mekelle, the capital of the northern province of Ethiopia, 15 patients were treated in the cath lab with large, persistent ductus botalli (PDA) *. In 12 cases the closure was successfully performed by catheter-based procedure with the Nit-Occlud PDA-R system from PFM-Medical. In three cases, PDA's were larger than the available closure systems. These patients will be registered for surgery.

he workshop was organized by the association Etiopia-Witten from Germany and the cardiologists of the Ayder Hospital. He was conducted by the interventional pediatric cardiologist Prof. Dr. med. Nikolaus Haas, the director of the Department of Pediatric Cardiology and Pediatric Intensive Care Medicine of LMU Ludwigs Maximilian University, University of Munich Germany.

AIn the morning, simulator training was done in the Ayder Heart Catheter Laboratory on a silicone / iodine heart model with a PAD, developed by German medical students at the University of Munich. the model had been printed using a 3D printer. The simulator training was done with original but expired catheter materials. The patients enrolled were examined in advance clinically and echocardiographically. Over the next few days, Prof. Haas provided a step-by-step guide to measure the size of the duct by X-ray angiography and placement of the closure device in the PDA. At the end of the workshop, the most experienced Ayder cardiologists  were able to successfully carry out the procedure independently.

The financing of the expensive single use materials and the closure devices was taken over by Mekelle University.

* A PDA is characterized by the persistence of a normal fetal connection between the aorta and the pulmonary artery through which erroneously oxygenated (red) blood circulates  through the lungs. A big PDA can cause serious negative consequences. In addition to early lung failure, severe, permanent damage to the lung tissue can develop. Also bacterial infections of the heart are possible.

The End