But with eight operations scheduled last week at Kapiolani Medical Center for Women and Children, none of the cardiac doctors saw much daylight.

Lamberti, pediatric cardiac surgeon at San Diego Children's Hospital, was in the news earlier this year for surgically separating Siamese twins. He has been coming here since August 1994 as a "mentor" for Kapiolani's pediatric cardiac group, headed by Dr. Carlos Moreno-Cabral.

"It's been fun to watch the program grow," Lamberti said.

Already this year, Kapiolani has had 15 pediatric open-heart surgeries, said Merla Takenaka, pre-admission coordinator. And Moreno-Cabral has at least one operation scheduled next week, she said. In the same period last year, there were six cases.

At this rate, about 40 open-heart patients are expected this year, double last year's number, said Dr. Alan Britten, Kapiolani pediatric anesthesiologist and intensive care specialist.

Lamberti comes here at least every two or three months to assist with more-complicated cases. He said the San Diego Children's Hospital does about 200 open-heart operations annually.

When he's here, Britten said, "We work him hard. In truth, I say goodbye to my family Monday morning. We work through the week."

Britten said he used to go Queen's Medical Center to help with open-heart surgery on children but Queen's had no pediatric intensive care program. Once children were stable, they were transferred to Kapiolani.

He said he suggested developing a cardiac program at Kapiolani eight years ago. "It took three years to get it together - all the pre-op, surgical and intensive care in one facility."

Now, most open-heart surgeries in Hawaii on children under age 15 are done at Kapiolani, Britten said.

The hospital formed a "Kardiac Kids" group that meets monthly at the hospital to support families with children who have heart problems.

A Kapiolani Pediatric Cardiac Surgery committee developed and manages the open heart surgery program. Members include pediatricians, cardiac surgeons, social workers, operating room and pediatric intensive care unit staff, anesthesiologists, blood bank personnel and a pre-admission coordinator.

The team has gradually taken more difficult cases since Kapiolani's first open-heart patient five years ago.

Moreno-Cabral is attending cardiac surgeon for Queen's, Kuakini and St. Francis Medical Centers, as well as Kapiolani. He directs the Hawaii Cardiac Transplantation Program at St. Francis Medical Center and is a consulting surgeon for Tripler Army Medical Center.

He said Mellorrie Gander's case last week was about the most complex being done here. However, a rare abnormality prevented the 2-year-old's surgery. Her operation eventually will be done at a mainland hospital equipped for more-demanding cases.

Other patients last week ranged from ages 41/2 months to 8 years. Two were from American Samoa.

All have left the hospital except one who had surgery Friday, Takenaka said.

Moreno-Cabral said Kapiolani has done about 100 open-heart operations since the program began, with "good results so far." Only one or two deaths have occurred, he said.

Since he's been with the program, Lamberti said, he has seen it grow "not so much in terms of outcome but in terms of efficiency...

"What makes it routine is everyone on the team knows their role and plays their role to perfection."

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