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The heart makes it without missing a beat


10 May 2004
The Hindu
By T.Lalith Singh

HYDERABAD: Neatly wrapped in a sterile bag and placed in an icebox, the heart embarked on a bumpy ride from Nampally to Banjara Hills. Time was of prime essence. Police outriders led and cleared the route for the ambulance in its race against time. And hours after it was removed from an 11-year-old brain dead, the heart began throbbing for a terminally ill 23-year-old.

A team of doctors at the Care Hospital performed the second cardiac transplantation in the State that gave a fresh lease of life to a youngster who had an end-stage heart disease with refractory heart failure.

According to Gopi Chand Mannam, who led the transplant surgery, the patient with a complaint of breathlessness caused due to problems of blood pumping, was admitted at the Care Hospital, Banjara Hills. "He had stopped responding to medicines and heart transplant was the only way out for him as the condition kept turning critical," he said.

When news of K.V. Aditya Kaushik, the 11-year-old boy admitted at Nampally centre of the hospital was certified as brain dead, Multi Organ Harvesting Aid Network (MOHAN) Foundation, the voluntary agency involved in promotion of cadaver organ transplantation, was informed. Once the parents of Aditya consented for organ donation after counselling, doctors decided to use the heart for the critically ill patient at Care Hospital.

Since the donor was in Nampally centre and the recipient at Banjara Hills, the doctors harvested the heart at Nampally centre itself and shifted it for transplantation. Doctors said the assistance of the city police was sought for quick transfer of the organ to hospital's Banjara Hills centre by avoiding traffic congestions. "The police provided escort which cleared the road for our ambulance and we could cover the distance in just under eight minutes," Dr. Mannam said.

The surgery was performed late on Sunday night and the recipient was said to be responding well on Monday morning. Doctors hope to remove artificial support in a day or two and said, "In time, the heart will adapt to the new environment."

Apart from heart, the boy's other organs too were harvested and transplanted. Global Hospitals carried out a child-to-child liver and kidney transplant, described as the first such effort in the State. "A 17-year-old girl from Surat was transplanted with the liver and an 18-year-old boy from Gorakhpur with twin kidneys," a press release said. The liver transplant was carried out by a team led by Mohammed Rela and the kidney transplant by G. C. Malakondaiah. The L.V.Prasad Eye Institute also harvested the eyes for transplant.


Hrudaya to do free heart surgeries for CHD affected poor children



5 August, 2005: Every year nearly 2 lakh children are born in India with congenital heart disease (CHD) adding to the existing millions suffering from the disease. Of these only 6 to 8 percent of them receive medical treatment. The rest either don't get timely treatment or their parents simply cannot afford the cost of surgery and treatment, which is true in a majority of cases. Shockingly, in India each year about 121,000 cases of adult CHD cases reach the age of 15 years due to lack of health awareness, poverty and inadequate healthcare facilities. This startling revelation was given by Dr. Gopichand Mannam, the Managing Trustee of Hrudaya Foundation, a charitable trust that does free treatment for underprivileged children afflicted by congenital heart disease. 

Dr. Gopichand reiterated the need for greater focus on this ever increasing and enormous disease burden and said, ?Congenital heart disease is a growing and a neglected problem in India. Due to lack of facilities, money or awareness, CHD patients in India often live and die untreated. This is extremely ironical considering that all forms of CHD are completely treatable by surgery and medication, after which a child can look forward to a normal life. We need the community action to rid our country of the curse of Congenital Heart Disease.' 

Dr. Nagarjuna Ponugoti, Managing Trustee of the US based ?Cure A Little Heart Foundation', the organization which helped Hrudaya's fund mobilization in the United States, added, ?Children are the future, and we don't see what we do as charity. It is a necessity. If we don't protect the children today, mankind will suffer tomorrow. The important thing is to act - and act now!' 

Recently, Dr. Gopichand mobilized US $ 2,00,000, with promise for another $100,000 by the end of this year, from NRIs across the world to aid his treatment of CHD. Elaborating on the initiative he said, ?Hrudaya Foundation, in collaboration with the US based Cure a Little Heart Foundation organized a charity dinner to fund free heart surgeries in India. To our delight, we mobilized the expected amount, which will go towards saving the lives of 200 to 250 children suffering from Congenital Heart Disease. This is real community participation and we can get rid of the disease only if socially conscious individuals and communities come together in this endeavour.' Support to the cause can come in various ways, and a case to point is the contribution of Pragati Printers, the leading printing house in the country, which designed & printed of the brochures for the Hrudaya's recent fund mobilization drive. 

Hrudaya regularly conducts free CHD screening camps and plans to take the screening camps to every part of India. Further, the charitable trust sponsors free surgeries for underprivileged children afflicted with the disease and bears all costs of surgery. In the last one year Dr. Gopichand has successfully conducted more than 400 free operations on poor children afflicted with CHD. 

Hrudaya Foundation, a non-profit organization, has been established primarily to raise funds that will be used to provide treatment to poor children affected with congenital heart diseases. Hrudaya also strives to create awareness about congenital and acquired heart diseases among general masses and doctors. Leading industrialists, corporate heads, and doctors are its patrons. To know more on Hrudaya and its activities log on to http://www.hrudaya.org/ 

The Good Samaritan


Ailing hearts get free treatment from Dr. Gopichand 

MODEL DOC Dr Gopichand with one of his little patients

His puzzled looks seem to convey something to his mother Vani. But he is too small and feeble to express it. The only consolation he gets is some continuous caressing from parents Vani and Sudhakar. But there is also little the couple from Khanapur, Warangal, could do to alleviate the agony of their seven-month old yet-to-be named son, who faced the surgical scissors to escape the jaws of death.

A month after the child was born Sudhakar and Vani were distressed to know that the little one was diagnosed with a hole in the heart. Doctors in Warangal suggested the child be taken to Hyderabad for surgery.

But with the meagre Rs. 2,500 earnings, Sudhakar lacked the wherewithal to go for the expensive surgery that would cost Rs one lakh. The couple had almost given hope of their child, when they happened to come across P. Jairaj Kumar, a businessman. The latter in turn got touch with Gopichand Mannam, chief of cardio-thoracic surgery, who immediately volunteered to perform a free surgery on the child at the Care Hospital, Banjara Hills. The couple now feel ever indebted to the doctor for the gesture.

In the case of B. Shanmuga Chary, a retired RTC Inspector he had spent about Rs.1.5 lakh for his 22-year old unmarried daughter Srujana's heart's surgery. Father of four unmarried daughters, Chary had to foot the bill from his retirement benefits savings. With hardly any savings left, Chari was helpless when, Gopichand on coming to know of his plight offered to waive the bill completely.

But for Gopichand who is a claimant to several unique operations, performing such free surgeries is nothing new. He seems to be on a record-breaking spree by performing hundreds of such free heart operations on children.

The city- based doctor has swelled his own scorecard with 400 free heart operations on children. Apart from that he is also credited with the claim of having performed 4,000 operations on the general public.

Unique surgeries

His forte being, congenital cardiac surgery and coronary artery bypass surgery on a beating heart, Gopichand was the first to do a heart transplantation using an undersized heart. The donor in that case was a 10-year old boy and the recipient was 23 years.

Soft and affable, Dr. Gopichand has many other "first" to his chequered career. He was the first to do the minimally invasive ASD closure, first robotic heart surgery in southern India and also an open- heart surgery with a 6 cm incision. Gopichand has now come out with another innovative project-Hrudaya a non- profit organisation

to comprehensively deal with heart problems in children under 12 years of age. His friends have started a similar foundation called "Cure a Little Heart" in the United Statesto help Hrudaya realise its Mission.

According to Gopichand, the trust is being set up with an initial amount of $ 250,000 . A number of well meaning individuals including a top film personality from the city has come forward to contribute to the cause. Several doctors and NRIs working in the US have also expressed their desire to make their contribution for the trust, says Gopichand.

Joint efforts needed

Every year about two lakh children require heart surgery in the country. Depending upon the nature of the surgery, it costs anything between Rs. 75,000 to Rs. four lakh. "Since it is beyond the capacity of any government to provide for the treatment of such large number, it is the duty of all sections of society to contribute its might for the cause," says Gopichand.

He argues that even in developed countries like the US and UK, NGOs, corporate houses, individuals and Government agencies coordinate their activities to provide Medicare for the citizens. The Government had been approached for providing tax exemptions towards contributions made to the trust, he adds.

Hyderabad doc demonstrates India's capabilities in new era cardiac care


City doctor performs minimal invasive Bypass using robotic equipment

7 June, 2005, Hyderabad: For decades, science fiction has been promising a future filled with robots that will make the various annoyances and dangers of life easier or more bearable. Robotics changed manufacturing in the '70s and '80s. Today, a new generation of robots is making a significant difference in medicine and surgery and could conceivably change the way that we deal with disease. Robots, which help create minimal invasions for surgeries are extremely precise and are transforming the way heart disease will be treated forever.

Recently, Care Foundation funded the acquisition of a new surgical robot called daVinci System to create a unique landmark for heartcare in Southern India. After Delhi, Care Hospital's acquisition has created history as the second city in the country to acquire this equipment and expertise. Dr. Gopichand Mannam, an eminent Cardiothoracic surgeon who has completed over 6000 surgeries so far, recently operated on a 45 year old patient using this robotic equipment in Hyderabad. Speaking to the press on the occasion, Dr. Gopichand addressed, ?The robotic surgery is a boon to heart patients who will now only need minimal invasions, even for heart surgeries like revascularization & valve replacement. Over time, robotic heart surgeries will attempt not to open the chest at all to do operations on the heart. Though there is still some way to go for that, this first step taken by us is a great beginning.'

Dr. Gopichand and a few colleagues went to the United States last year to get trained in these new techniques using robots and practiced on the daVinci equipment to equip and train & equip themselves. The first patient, a 72 year old male, was successfully operated for Bypass using the robotic equipment about one month ago and the second such patient, a 45 year old labourer, was operated for Bypass Surgery on Saturday, 4th June, 2005. Dr. Gopichand elaborated on the procedure and said, ?The recovery time using robotic surgery is phenomenal because of the small incisions. There is also no need to cut of any bones for the surgery. It is fascinating to see the patients go home within 5 days. The robotic arms which have been modeled after the human wrist allow a full range of motion, transposing the action of the finger tips to the robotic instrument.'

The advanced robotic equipment and trained doctors on the equipment, firmly places Hyderabad as among the most advanced medical hubs in the country.

Dr. Gopichand Mannam graduated from Guntur Medical College, Guntur, AP, in April 1981. In May 1981 he went to Jamaica, West Indies, where he developed his initial skills in surgery. In 1983 he went to the UK to pursue his career in general surgery. He passed FRCS in General surgery from the Royal College of Surgeons, Edinburgh, in 1986 and The Royal College of Surgeons, Glasgow in 1987.

In November 1994, he came back to India and joined the Apollo Hospital, Hyderabad, as a senior Consultant in Cardio-Thoracic surgery. Later, in June 1997, he has joined Medwin Hospital, Hyderabad as Consultant Cardiothoracic Surgeon. Currently, for the past 5 years, he is at CARE hospital, Banjara Hills as Chief of Cardiothoracic surgery. His main interests are congenital cardiac surgery and Coronary artery bypass on a beating heart (OPCAB). So far he has done more than 6000 heart operations.

Dr. Gopichand also does hundreds of free cardiac surgeries on children every year. He is also the Managing Trustee of ?Hrudaya', a charitable trust that helps finance free heart surgeries for the children of the underprivileged.


NRIs pitch in to treat kids with heart ailments


K.V. Kurmanath


COME June 18, a large gathering of expatriates from India, mostly from Andhra Pradesh, would be gathering at Hotel Hilton Irvine, Orange country, in California to raise funds to treat children suffering from heart diseases in their native country.

Worried over reports that about two lakh children are born every year in India with heart diseases, a group of NRIs in the US, mostly doctors and software professionals, have set up `Cure a Little Heart Foundation'.

Back in India, friends of these NRIs have formed `Hrudaya Foundation'. This list includes leaders from corporate houses such as Karvy Consultants, Ocean Sparkle Ltd and Genova Biotecnics.

The NRIs and their friends in India have centred their activity around Dr Gopichand Mannam, a well-known cardio thoracic surgeon at Care Hospitals in Hyderabad.

"The idea is to mobilise funds that can be utilised to attend to the heart problems of these hapless children," Dr Gopichand told Business Line.

Dr Gopichand, who is already championing the cause of children suffering from congenital and acquired heart diseases, says the two foundations aim to come to the rescue of these children.

"We are confident of raising $2,50,000 on June 18," Dr Gopichand says.

He adds that the two trusts strive to evolve a sustainable fund to help more and more patients in the long run.

"The problem is huge. The Governments cannot handle this kind of problem," he pointed out.

Majority of the children afflicted with heart diseases die not because of ignorance but because of lack of access to quality healthcare services.

Joining him in the activity are, Mr M. Yugandhar, Managing Director of Karvy Consultants, Mr P. Jairaj Kumar, Chairman and Managing Director of Ocean Sparkle Ltd, and Dr Mitra P., Chairman and Managing Director of Genova Biotechnics.

Dr Gopichand, along with Mr Jairaj Kumar and Mr Yugandhar, would leave for the US next week to promote the idea.

"On an average, a heart intervention costs around Rs 75,000 to Rs 1 lakh. We, doctors, charge no fees, while the hospital provides subsidised services," he said.

"We see 50 patients a month, who need operation, at this hospital," he said.

Initially, the trust will channelise the funds mobilised by their US friends. In the long term, the two trusts plan to create a good track record. "With that track record, we will approach more corporates, charities, organisations and individuals." Dr Gopichand said.

In the last 11 months, Care has performed 400 surgeries on children free of cost. The NRI doctors' support is beyond pecuniary. "When they come to India on vacation and other trips, they would visit the hospital and help the staff update themselves on relevant topics," Dr Gopichand said.

Specialist clears the air on organ donation


By Our Staff Reporter

HYDERABAD, MAY 21. Doctors at Care Hospitals, Banjara Hills, have said that the heart transplantation carried out on a patient, Rama Rao, on May 9 was successful and the patient should be able to leave the hospital in a week.

Addressing the press on Friday, Gopichand Mannam, the leader of 25-strong team of doctors involved in the process of harvesting, transporting and implanting the organ, said that heart transplantation was the only option for many patients with chronic heart failure. Of the 12 patients at Care Hospitals who were diagnosed with similar chronic heart failure, only two survived today, Dr. Mannam said.

But there were hardly any donors due to lack of public awareness and the social stigma involved. Despite the fact that organs could be harvested from only about 18 per cent of those diagnosed as "brain-dead", many more people with fatal diseases could receive organs if there was more awareness among people and better medical infrastructure, said P. Krishnam Raju, a cardiologist on the team.

About 8,000 people die in road accidents alone in the State every year but almost none became organ donor due to lack of timely intervention and opposition from relatives, he said.

In the case of 10-year-old Aditya Kaushik, his parents agreed to donate his organs even in their time of grief. This gesture gave a new heart to one, a new liver to another and a new pair of kidneys to a third person all of whom would not have survived if not for this noble act. His eyes too gave sight to two persons.

B. Soma Raju, Chairman, Care Hospitals, said they had taken the help of Mohan Foundation to counsel relatives of those who have died to donate their organs and thus "immortalise" them. The hospital had recently employed a full time "transplant coordinator" to help with such procedures.

This is the second case of a successful heart transplant in the city in as many months. Even though each such operation costs about Rs. 5 lakhs, it can be covered by insurance. Also if there was a proper system of organ harvesting and transplantation put in place in the State costs would come down substantially, Dr. Soma Raju said. In this particular case, Care Foundation had borne the costs since the patient was a poor person.

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