Dr. Ravi Yarlagadda meets the local press to discuss his project

Greetings from India!  A very long journey (25 hours of travel:  8 hour flight from Hartford to Amsterdam, Netherlands, 5 hours layover, 8 hour flight from Amsterdam to Hyderabad, India, 4 hour drive south to Vijayawada) has brought us to my hometown of Vijayawada in Southeastern India.  Summer has not quite arrived, so the weather is clear and temperate.  A very good time to visit and implant life-saving cardiac devices in needy patients at NRI Hospital and Medical School

NRI Hospital is a 500 bed facility near Vijayawada.  It was founded predominately to provide quality medical care for indigent patients.  Needy patients comprise the bulk of their admissions and procedures.  NRI also provides top-notch care

NRI Hospital near Vijayawada, India

for patients with some ability to pay for their procedures, but at a very nominal rate.  For example, a cardiac bypass procedure is charged at the equivalent of roughly $1,000.  The cardiologists at NRI screened patients prior to our arrival for indigent status and cardiac conditions that qualify them for implantation of one of our donated cardiac pacemakers or implantable defibrillators (ICDs).  The cardiac procedure room (cath lab) at NRI is very modern and I soon felt right at home meeting my patients and their families and performing today’s implant procedures.

 

Today I implanted two defibrillators and one pacemaker specialized for the treatment of advanced heart failure -- a cardiac resynchronization pacemaker, also called a CRT-P. While these patients had no ability to pay for the devices they received today, all were actively trying to maintain their employment and to contribute to the support of their families. 

 

However, left untreated, their cardiac conditions were severely limiting their abilities and ultimately, long-term prognoses:

 

All of these implant procedures went very smoothly.  While the available implanting tools and cath lab equipment at NRI were very similar to Hartford Hospital’s, I did see some differences between procedures in each facility.  At Hartford, only essential personnel are in the lab during a device implant procedure.  Usually this includes me, an anesthesiologist, a scrub nurse, a circulating nurse and an engineer from the device manufacturer.  Today at NRI we had at least 10 people in the lab during our procedure.  Many had specific roles, like operating the lab equipment, but some seemed to be there out of professional curiosity (although they were very quiet and unobtrusive.)  Certainly advanced implant procedures like we performed today are not routine at NRI as they are at Hartford.  We were in the spotlight!

 

The spotlight continued in the afternoon.  A press conference was held for me, NRI’s board of directors, and nine members of the state’s (Ahndra Pradesh) newspapers and television stations.  I can’t say I particularly enjoyed speaking into the microphones and camera lights, but it was important to publicize the good work that this implanting project and NRI hospital are doing for the needy of this community.  The hospital is not charging for any part of the procedure, care or medications patients receive as part of this implant program.  Nothing better emphasized how important this implanting program is than the patient’s families I spoke with after each procedure.  Many were grateful to the point of tears. 

 

This has been a long day and I am very tired.  It is late in the evening as I write this but as Vijayawada is 9 hours ahead of Hartford, it is only mid-morning in Connecticut.  Tomorrow I will present two professional lectures to the area’s cardiologists and internists about the latest information about the diagnosis and treatment of heart rhythm disorders.  I will also implant three more cardiac devices in needy patients. 

 

Dr. Ravi Yarlagadda