It is a well established fact that cardiac disease is the number one cause of death worldwide and it is no different in India. While there are several critical care centres in India, across all districts, significant number of them do not have the critical facility of a Cathlab.

The disease incidence and emergency nature of the disease warrants availability of a cathlab at the nearest possible location in each district. You need to look at how the patients in your district are being treated today for initial diagnostics as well as interventional procedures.

Cathlabs till now are perceived as a very expensive equipment with installation taking anywhere between 6-8 weeks. Typically installation involves construction of a specific suite or building, special electricity and other arrangements that would cost around 15 - 30 lakhs. Breaking even is difficult if there are not enough cases.

Today, there is a breakthrough system that can bridge all these gaps, the GE OEC 9800.

The GE OEC 9800 can address a vast range of vascular applications where you need it, when you need it, from the ER to the OR to the ICU. OEC 9800 requires less than a day to install and provides simple break-even.

GE OEC 9800 is the first cardiac C-Arm with true 1k x 1k imaging and it produces images
that must be seen to be believed. With the 1K2 imaging technology, GE OEC has broken a barrier that has previously separated the capabilities of mobile systems from those of fixed cath-lab imaging systems - with true 1k x 1k imaging resolution throughout the imaging chain. The result is a new and powerful digital imaging system with exceptional image capture, management and recording capabilities. The 15 kW, 60 Hz battery-buffered, high-frequency generator provides pulsed, digital cine techniques up to 150mA at 30 pulses-per-second with 10 millisecond pulse widths (upto 25 pps in 50 Hz systems). Motion artifacts in complex vascular procedures are virtually eliminated. High power, rapid pulses allow the system to capture clear images of vascular anatomy, even during the most demanding bolus chasing or coronary angiography procedures. And... all of this while powering the OEC 9800 Plus from a standard wall outlet.

• Your patients need comprehensive cardiac care locally.
• You encounter cardiac emergencies which require primary angioplasty within the Golden Period.
• You are referring your patients with MI to other Centres.
• You want to expand into invasive cardiology.

• Every DM Cardiologist with OPD & Diagnostics.
• Every CCU with interventional cardiologist.
• Every > 20 bed Hospital with cardiology practice.
• Every super speciality wishing to diversify into cardiology.

It’s a no compromise Lab...

Dr. Praveen Chandra - Consulting Cardiologist at Escorts Heart Institute & Research Centre, New Delhi has performed over 500 Angioplasties and Valvuloplasties on "Cathlab on Wheels" - the OEC 9800 Cathlab that was made available on a custom built Cathlab Suite on a Van. EHIRC has partnered with local hospitals and specialists to create awareness and also provide the angiography opportunity to the needy people in smaller towns.

What is the role played by technology in the whole program?

The technology used in the OEC 9800 has an important role. We could easily transport the OEC 9800 and as soon as it arrived, we plugged it in and started the procedures.  bThat is how we did the first ever angioplasty in Nepal! OEC 9800 has the distinct advantage in terms of it being a fairly easy, user-friendly machine and does not have any breakdowns. It is a small machine, easy to handle, not many switches. "It is just switch it on and start".  We have done 250-300 angiographies and several valvuloplasties in Nepal.

Yes, we went to Bikaner primarily to do angiographies first because there were a lot of patients who cannot afford to come down to Delhi. We could perform close to 300 angiographies in 6 months and we have done quite a fair number of procedures in a single day - that was 27 angios in a day!

There is no compromise on quality and the images are digital with good delineation of anatomy even for imaging of complex PTCA.

Even if you have a machine three times bigger, it will provide the same quality for routine angiography studies. The image quality is very good and you can have frozen images and loops so that you can see pre and post procedure.

The largest number of procedures in a day was 27 angiographies and the second is that we did the largest number of angioplasties which was about five angioplasties and seven angios in a day - starting from 8:00 a.m. and continuously using the system till 6:00 p.m. The longest PTCA was the double vessel PTCA which
took nearly an hour. There was no disturbance on the image quality, nor did we have to stop
in between.

I think for routine angiographies, there
is no requirement for surgical back-up facilities, but for angioplasties or any interventions,
I think there should be some preparedness for surgical interventions - that is from an emergency perspective.

Dr. K.G. Ramakrishnan and Dr. Suraj Menon, Malabar Institute of Medical Sciences, Calicut, share their experience:

A 31-year-old lady was undergoing treatment for primary infertility even after eight years of her marriage. Investigations revealed the presence of multiple large uterine fibroids and she was advised to undergo hysterectomy.

Uterine fibroid embolization was considered an option to give her a chance for pregnancy. The right ovarian artery, originating from the uterine artery was noticed during the angiography (1k x 1k) and extreme care was taken not to block this. The high resolution imaging of OEC 9800 helped the radiologists in selectively embolizing the fibroid bed.

The lady is on regular follow-up and she is now pregnant. "Without OEC at this center, she would have undergone surgical removal of her uterus and would have permanently lost the chance for pregnancy".

Back Issues
 We bring Good Things to Life
   Issue 38, July 2002