The beat goes on


POSTED: Saturday, April 25, 2009

A unique program at Kapiolani Medical Center for Women and Children has saved hundreds of isle families the expense and hardship of having to take their children to the mainland for heart surgery.

Pediatric heart specialists have treated more than 1,000 children with open heart surgery and other cardiac procedures since Heart Week began in 1995 at the hospital. The most recent Heart Week was held April 6-10.

Thoracic surgeon Dr. Carlos Moreno-Cabral heads the program, which he has developed with Dr. John Lamberti, leader of the pediatric surgery program at Rady Children's Hospital in San Diego.

Lamberti comes here five times a year for Heart Week, working with pediatric specialists on more complicated open heart procedures.

Dr. John Moore, an interventional cardiologist and medical director at Rady Hospital, does cardiac tests and treats defects with catheterizations at Straub Clinic and Hospital.

In an interview with Moreno-Cabral and Lamberti after their seventh Heart Week operation earlier this month, Lamberti said the complexity of the average case has increased with the team's expertise, he said.

Moreno-Cabral said the team has done 450 open-heart surgeries since the program began. They do 35 to 40 operations annually during Heart Week and about 100 non-open-heart procedures, he said.

“;If we think they would be better serviced at an institution with higher levels of technology, we would transfer them,”; Lamberti said.

Moreno-Cabral has expanded Kapiolani's program with a federal grant for a technique known as extracorporeal membrane oxygenation, providing cardiac and respiratory support oxygen to newborns.

The Kapiolani pediatric program collaborates with Tripler Army Medical Center and Kaiser's Moanalua Medical Center, as well as Straub, the surgeons said.

“;I recognized all of the pieces necessary to run the program were already here in Hawaii,”; Lamberti said, “;and what the program just needed was a little bit of structure it could only get from a higher volume program. ... We wanted to create something that would allow surgery to be done when we weren't here.”;

All cardiologists in the community meet at the end of every Heart Week to review patients and make decisions about tests and operations, they said.

“;There is probably no other state where everybody gets together so collegially,”; Lamberti said. Many things make it a model program.”;




Making hearts healthy


        Heart defects in Hawaii's children:

» An estimated 120 children need surgery annually for congenital heart defects.


» About 60 operations are done during or between Heart Week, a program held five times a year at Kapiolani Medical Center for Women and Children.


» About 50 or more children go to mainland institutions annually for heart operations, mostly to Rady Children's Hospital in San Diego.


» About 450 open-heart surgeries have been done at Kapiolani since Heart Week began in 1995 with specialists converging from Hawaii hospitals, Children's Hospital in San Diego, Stanford University and the University of California Los Angeles.


» The team does 35 to 40 operations annually during Heart Week and about 100 non-open-heart procedures.


Sources: Drs. Carlos Moreno-Cabral and John Lamberti