BD doing fine in cardiac surgery: Dr Asit

Prof Dr Asit Baran Adhikary, one of the country’s leading cardiac surgeons, successfully conducted bypass surgery without the use of anesthetics. 

He is the chairman of Cardiac Surgery Department and chief of the special unit at Bangabandhu Sheikh Mujib Medical University. 
During his successful career in cardiac surgery, he has received Gold Medal from the Government of Bangladesh in addition to many national and international awards. 
In an interview with Bangladesh Post, he answered many questions on heart-related diseases. The interview was conducted by Mehedi Hassan Munna.
Any type of heart-related problem beginning from the womb to any age is called heart disease.
BD Post: What are the kinds of heart diseases?
Dr Asit: There are various kinds of heart diseases such as – (1) congenital heart disease or by-birth heart disease (2) Rheumatoid arthritis (3) Coronary artery disease (4) Cardiac tumors (5) Microbial Cardiac Infections (6) Heart block or conductive abnormalities.
BD Post: When do congenital heart diseases occur, and what are the kinds?
Dr Asit: At the age of 20 days of an embryo in the mother’s womb, our heart starts to proceed, and heart diseases begin for various complexities from this stage, to the next three months. Most of these embryos die in the womb, the rest of them are born with heart disease. Such by-birth heart diseases are divided into two groups: 
Cyanotic Heart Disease or blue baby disease, that occurs due to deoxygenated blood bypassing the lungs and entering the systemic circulation, or a mixture of oxygenated and deoxygenated blood entering the systemic circulation. 
It is caused by structural defects of the heart (i.e.: right-to-left, bidirectional shunting, malposition of the great arteries), or any condition which increases pulmonary vascular resistance.
Acyanotic heart defect, is also known as non-cyanotic heart defect.  In these, blood is shunted (flows) from the left side of the heart to the right side due to a structural defect (hole) in the interventricular septum. 
People often retain normal levels of oxyhemoglobin saturation in systemic circulation. 
BD Post: Why do congenital heart diseases occur?
Dr Asit: These problems may occur alone or together. Most children with CHD do not have other types of birth defects. However, heart defects may be part of genetic and chromosomal syndromes. Some of these syndromes may be passed down through families.
Often, no cause for the heart disease can be found. Congenital heart diseases continue to be investigated and researched. 
Drugs such as retinoic acid for acne, chemicals, alcohol, and infections (such as rubella) during pregnancy can contribute to some congenital heart problems.
Poorly-controlled blood sugar in women who have diabetes during pregnancy has also been linked to a high rate of congenital heart defects.
BD Popst: What are the symptoms of Congenital Heart Diseases?
Dr Asit: Excessive sweating, extreme tiredness and  fatigue , poor feeding, rapid heartbeat, rapid breathing, shortness of breath, chest pain, a blue tinge to the skin (cyanosis), and clubbed fingernails are the common symptoms. 
BD Post: How can Congenital Heart Diseases be treated? 
Dr Asit: If by-birth heart diseases are diagnosed, it is rarely possible to treat without surgery. There are even some defects which must need surgery after birth, otherwise, it might be tough to save the baby. After all, there are a few diseases that can be treated normally, whereas most of these have to be cured by surgery only.
BD Post: What is the position of Bangladesh in heart surgery at present?
Dr Asit: I think, we are not so far behind in comparison to other countries in heart surgery. We have more developed in this area than earlier. 
BD Post: How many types of surgery you do usually perform?
Dr Asit: The surgeries I do are divided in two types: one is ( a)normal surgery, the other is (b) complex surgery. PDA, shunts, coarctation of the aorta, ASD, VSD, TOF are among the normal surgeries.  TGA, TAPVC, DORV, Artesia etc are the notable complex surgeries. 
BD Post: What is the mortality rate for both types of surgeries?
Dr Asit: The mortality rate in normal surgeries is mostly lower than 4 percent, comparable to other developed countries. Again, 5 to 10 percent mortality rate stands for complex surgeries in the whole world. Here it is also the same.  
BD Post: What is the cost of cardiac surgeries in this hospital?
Dr Asit: We provide the lowest surgery cost in this hospital. Different heart surgeries are conducted at different costs.  For example: A bypass surgery costs only TK 90,000 here.
BD Post: What number of surgeries have you conducted in this hospital?
Dr Asit: It is very tough to say the exact number. We have had some 450 plus surgeries in our department. The mortality rate is less than 4 percent for children and 5 to 10 percent for adults. 
BD Post: Why are surgeons in our country not much reputed, and why are there allegations about them?
Dr Asit: Thank you very much such a nice question. You have known earlier about our surgery successes and costs (half of those in other countries). We are operating at reasonable costs both normal and complex surgeries. You have to be aware of the post-surgery mortality rates in other countries. 
There is no country where mortality rate is zero. No surgeon can conduct treatment with a guarantee, as it also depends on the grace of the Almighty. After surgery, many dead bodies come back to our country from abroad, but the news remains secret. 
On the other hand, if a patient dies after an operation, it is commonplace to witness doctors and staff being harassed, hospitals being ransacked, and even being highlighted in the media. I request our mass media not to provide bombastic allegations against doctors. I seek coordination in this matter. We have many doctors with potentials, and if their potentiality can be upgraded, our medical sector can contribute a lot. I request the mass media to highlight positive news so that patients can have positive attitude toward the sector.