Destination Spotlight

Taking Excellence to Heart

Destination Spotlight
Dr. Jorge Garcia is the man behind the excellent cardiovascular surgery success rates of Asian Hospital and Medical Center. The track record of the man and the hospital speaks for itself.


When it comes to heart surgery, Dr. Jorge Garcia knows that the harmony of details is what creates the symphony in every successful surgery. That’s why one of the best cardiovascular surgeons in the world took an active role in designing the Asian Hospital Medical Center (AHMC) in the Philippines.

A properly designed cardiovascular unit is one of the factors that spell the difference between procedural success and failure. The location of the components of a cardiovascular unit, such as the operating room (OR), cardiac catheterization laboratory (Cathlab) and intensive care unit (ICU), must be integrated to enable the unit and its staff to operate smoothly and efficiently.

Dr. Garcia, a Clinical Professor of Surgery at Georgetown University in Washington D.C., worked with an American architect in drawing up floor plans for the state-of-the-art AHMC cardiovascular unit.  He has also designed cardiovascular units in hospitals in China, Egypt and the U.S., after which the AHMC cardiovascular unit was patterned.

“Aside from an optimally designed cardiovascular unit, successful cardiovascular surgery requires teamwork and repetition,” reveals Dr. Garcia, who completed his cardio-thoracic surgery fellowship training at the Cleveland Clinic in Ohio and is currently Senior Attending Cardiovascular Surgeon at Washington Hospital Center in the U.S. capital.

“Surgeons, anesthesiologists, intensivists, nurses, and technicians need to work together as a team to perform a particular cardiovascular procedure in the same manner every time with no or minimal variation,” he explains. “A set routine done repeatedly helps minimize mistakes.”

Excellent Success Rates

Dr. Garcia’s trademark of meticulousness and dogged adherence to quality control, have paid off. From March 2002 to December 2007, his team at AHMC performed 750 major cardiovascular procedures ~ most of them high-risk operations ~ with a very low overall mortality rate of 2.9%. The U.S. Society of Thoracic Surgeons (STS) Database, the global benchmark for heart surgery outcomes, has a 3.09% mortality rate covering six procedures involving bypass surgery and heart valve replacement or repair.  


When limited to the same number of procedures covered in the STS Database, the AHMC mortality rate goes down to 1.4%. To date, Dr. Garcia’s team at AHMC has done over 800 cardiovascular procedures.

Life-Saving, Innovative Techniques

Aside from the standard range of cardiovascular procedures, Dr. Garcia’s team also performs a lot of newer procedures.

OPCAB

Off-pump coronary artery bypass (OPCAB) is a surgical technique in which surgeons operate on the patient’s heart while it continues to beat and circulate blood throughout the body. Maintaining a highly controlled operative environment, surgeons use advanced operating equipment to stabilize portions of the heart and bypass the blocked artery or arteries.


OPCAB is indicated for high-risk cardiovascular patients with other existing diseases (e.g. diabetes) or blood clotting problems. It reduces the risk of complications commonly associated with conventional heart surgeries that require a heart-lung machine and minimizes blood transfusions.

Endovein Harvest

For the past 5 years, Dr. Garcia’s team has been routinely performing EndoVein Harvest, a minimally invasive procedure to harvest the saphenous vein.  Other local hospitals are just starting to do this. Located in the inside part of the leg and extending from the ankle to the groin, the saphenous vein is often used as a conduit during bypass operations. This innovative technique dramatically reduces complications commonly associated with the usual “open” technique of harvesting the saphenous vein, such as pain, edema and swelling, hematoma (bruising), and infection.

“EndoVein Harvest is definitely more aesthetic for and less traumatic to the patient because the saphenous vein is removed through a one-inch incision on the middle part of the knee,” explains Dr. Garcia. “It is the method of choice in major cardiac surgery centers in the US.”

Mitral Valve Repair

Instead of replacing the heart’s defective mitral valve, the usual procedure done in most Philippine hospitals, Dr. Garcia and his team repair it. The mitral valve is the valve that lies between the left atrium and left ventricle, the main pumping chamber of the heart.


This valve allows blood to flow from the left atrium into the left ventricle and then prevents the backflow of blood into the left atrium during ventricular contraction. “Valve repair maintains the natural anatomy of the mitral valve, which is why it is now the method of choice for the surgical treatment of mitral valve disease,” Dr. Garcia says.

Left Ventricular Remodeling

Dr. Garcia and his team can surgically restore or remodel the left ventricle in patients who otherwise would have required a heart transplant. A heart attack can leave a person with a scarred left ventricle. With each heartbeat, this scar can thin and bulge out, eventually forming a dangerous aneurysm. These changes, along with other damage to the heart, may result in heart failure.


Initially, the heart is able to cope with having to pump harder; but over time, the extra work load causes the left ventricle to enlarge and lose its ability to pump effectively. “Reconstructive surgery restores the left ventricle to a more normal shape thereby enhancing its pumping capability,” explains Dr. Garcia.

MAZE

Dr. Garcia utilizes a cutting-edge technique called the Maze procedure to surgically treat atrial fibrillation, the irregular beating of the heart caused by faulty conduction of electrical impulses. In the Maze procedure, an energy source (radio frequency, microwave or cryothermy) is used to scar heart tissue in order to block abnormal electrical impulses and restore the heart’s optimal impulse conduction.

Other innovative procedures performed by Dr. Garcia’s team at AHMC include thoracic aneurysm repair and implantation of the left ventricular assist device (the “bridge to transplantation”) in critically ill patients who have no other recourse but to undergo a heart transplant.

Affordable, High-Quality Care

Before the advent of medical tourism, Dr. Garcia knew of many Filipino patients who initially wanted to go to the US for a heart operation but ultimately decided to undergo the procedure at AHMC. He also tells of many American patients with health insurance that would have subsidized up to 80% of the cost of a heart operation who chose instead to undergo the procedure in Asian Hospital.

Dr. Garcia believes patients make this choice for two reasons. “They want world-class quality medical care at a significantly lower cost and the world-renowned compassion and personalized care of Filipino health professionals.”


As medical tourism takes shape, more and more candidates will be exploring the option of going to the Philippines for their heart surgery.

About the Asian Hospital and Medical Center

Asian Hospital and Medical Center is partly owned and is an affiliate of Bumrungrad International of Bangkok. It is recognized to be a regional quality leader in healthcare. The hospital is run by a team of experienced professionals from around the globe such as the United Kingdom, Australia and Switzerland. Asian Hospital and Medical Center is a one-stop center of medical services ranging from checkups to cardiac surgeries. These services are delivered by over 700 internationally trained doctors in a high-class facility. “We offer affordable world-class quality care when you need it.” This, in a nutshell, is Asian Hospital’s affirmation of its regard for quality medical care.

Eric Michael Santos is a freelance medical journalist based in Manila, Philippines. He has been writing about medicine and health since 1997. His work has been published in Medical Tribune, a monthly newspaper for health professionals, and HealthToday, a monthly consumer magazine, among others. He may be contacted at ericmichael.santos@gmail.com.

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