Uganda Heart Institute Review and Costs

Overview

Uganda Heart Institute started its treatment in a small clinic at Mulago Hospital in 1958. It started its full-fledged facility at UHI in 1988. It has been established as an autonomous body. UHI is a super-specialized service provider of cardiovascular services and the only National Referral Facility for heart diseases in Uganda. The heart institute has trained super cardiac specialists and installed a state-of-art Cardiac Catheterization Lab and OTs. By enabling all this, they have successful surgeries and interventions of world-class. UHI attends 20,000 patients annually. In 2007, UHI started carrying out Open Heart Surgery, and over 7000 heart operation has been performed. UHI handled over 95% of adult cases and 85% of children cases in Uganda.

Heart care is the most needed of an hour, and most people can access to that; for that reason UHI develops operationalized regional centers with the Ministry of Health and Regional Referral Hospitals. Back in 2015, it plans to build 200 beds and named the Uganda Institute of Cardiothoracic Disease and replace the current UHI. And the new hospital will have 3OTs, cardiac catheterization labs, an ICU, and research facilities. In 2016, UHI constructed a new complex that consists of 3 towers.
(a) 1st tower – Outpatient Clinics and hospital beds with an ICU.
(b) 2nd Tower – Research Labs and Conference rooms
(c) 3rd Tower – Research fellows, residents, and biomedical engineers.
And in 2022 UHI, Executive Director Dr. John Omagino disclosed that the institute plans to expand 250 beds, and, with time, it will, build 1000 beds. And the establishment state-of-art heart surgery and treatment center at Naguru in Kampala. It will be capable of performing 5000 heart surgeries annually.

Cardiovascular Surgery

About UHI

History

New Developments at UHI

• In 2018, 14 healthcare specialists performed 1st coronary artery bypass surgery operation. The surgery went on for 10 hours and was also successful.
• In Uganda first time catheter ablation procedure has been done on 11 patients with abnormal heart rhythms using the radiofrequency ablation method. And it has been benefited every patient, and they recovered well.

UHI recommends 6 Healthy Habits to strengthen your Heart

• Calm Down
• Exercise
• Lose Weight
• Stop Smoking
• Control Your Cholesterol
• Manage your blood pressure
• Uganda Heart Institute Services

UHI Medical Directors

• 1988 to 1998 – Dr. Francis Omaswa (Cardiovascular Surgeon)
• 1998 to 2008 – Dr. Roy Mugerwa (Cardiologist)
• 2008 to Present – Dr. John Omagino (Cardiothoracic Surgeon)

UHI Board of Directors

• Dr. Amone Jackson
• Dr. Birabwa D. Male
• Prof. Charles Ibingira Rukambura
• Grace Ndyareeba
• Harriet Lwabi
• Dr. James Magara
• Dr. John Omagino
• Peter Musoke
• Rosemary Kiwanuka

UHI Doctor’s List

• Dr. Lubega Sulaiman
• Dr. Ssemogerere Lameck
• Dr. Sebatta Ellias
• Dr. Opio James
• Dr. Omagino .O.O.John
• Dr. Oketcho Michael
• Dr. Tom Mwambu
• Dr. Mijumbi Cephas
• Dr. Peter Lwabi
• Dr. James Kayima
• Dr. Ejoku Joseph
• Dr. Aliku Twalib

Types of Heart Doctors

• Cardiologist
• Cardiovascular Anesthesiologist
• Cardiovascular Pathologist
• Cardiovascular Radiologist
• Cardiovascular Surgeon
• Perfusionist

Medical and Surgical Procedures

Clinical Tests Performed at UHI Laboratory

• Blood glucose
• Cardiac enzymes
• Coagulation tests like PT/INR, APTT, Thrombin Time, Fibrinogen, FDP
• D-Dimer
• Extended electrolytes
• FOBT [Fecal Occult blood
• HBA1C
• Lipid profile
• Liver Function tests
• Pro BNP
• Pylori Antigen [Antigen]
• Renal function tests
• Serologies [HIV1&2, HBsAg, HCV, H.Pylori]
• Special proteins [Pro calcitonin(PCT},CRP, hsCRP, ASOT, Rheumatoid factor {RF)
• Stool microscopy
• Thyroid function tests [T3,T3,FT4,T4,TSH]
• tPSA
• Troponin-I
• Uric Acid
• Urinalysis

Uganda Heart Institute Services

In-patient Services

–  24 hours services
– It includes adults’ and children’s admission
– Average stay at the ward is 5 days.
– Treatments Offered:

• Coronary care Unit: Heart Attacks, Cardiac dysrhythmia, unstable angina, and various other cardiac condition
• Cardiac Critical Care
• Cardiac Ambulance Service

Out-patient Services

Services offered are

• Arrhythmia and Pacing
• Hypertension
• Heart Failure
• Cardiomyopathies
• Paediatric
• Surgery
• Rheumatic Heart Disease

Cardiac Ambulance Services

• It includes
  • Competent team
  • Intervention according to the cause
  • Offers ACLS(Advanced Cardiac Life Support)
  • Identifying the cause of illness e.g.. heart attack, heart block, etc.
  • Skilled medical treatment
  • Supports breathing and heart functions by use of gases, drugs, and devices.
• Ground Ambulance
• 24-Hour Holter Monitoring

Other Services

• Cardiovascular Services
• Cardiovascular Emergency Management
• Cardiac ICU

Uganda Heart Institute Departments

Division of Pediatric Cardiology

Services available for out-patients

• consultations
• resting ECG
• 24-hour Ambulatory ECH
• ECG (Trans-Thoracic and Trans-Esophageal)
• Labs
• pharmacy
• Health Promotion Talks

Cardiac Problems include

• Tetralogy of Fallot
• Patent Ductus Arteriosus
• Holes in the heart

In-patient Services provides at UHI from consultation to the admission process. The team works hand-in-hand for pediatric cardiology surgeries

Pediatric Cardiac Interventions

• Division has 2 Pediatric Interventional Cardiologist
• Common Surgeries performed are
  • Balloon Atrial septostomy
  • Mitral Valvuloplasty
  • Device closure of Patent ductus arteriosus and Atrial Septal defects
  • Diagnostic cardiac Catheterization.

Outreach Services

• Services provided to the 13 Public regional referral hospital
• Established 3 strong presences at Jinja, Mbarara, and Gulu Regional referral Hospitals.

Division of Pediatric Cardiac Surgery

• This division has 2 Pediatric Cardiac Surgeons and Fellows.
• The team consists of Anesthesiologists, Perfusionists, Pediatric Cardiologists, Intensivists, Nurses, and Physiotherapists.
• Services offered in both Open and closed Heart Surgery.

Common Procedures are

• ASD and VSD closures
• Repair of Tetralogy of Fallot
• Coarctation repair
• Pericardiectomy
• PDA ligation

The above conditions refer to as Holes in the Heart, Blue Babies, and narrowing of blood vessels. These procedures are been carried out in UHI with modern equipment using the latest technology.

Division of Cardiac Critical Care

• The department is responsible for ensuring equipment for the critical care treatment of patients.
• Trained ICU staff and an Intensivist with a fully functional unit
• 6 fully equipped cardiac critical beds
• Currently, it has boosted the services, thus, now UHI separating its critical care beds into medical, surgery, pediatric, and adult patient critical care unit

Division of Cardiac Anesthesia

• It is an essential part of the emergency cardiovascular management team to provide anesthesia care for patients with cardiac illness undergoing cardiac operation.
• Cardiac Anesthesia is been operated on beforehand to evaluate and interpret of
  • cardiovascular and other relevant diagnostic test data
  • advanced level Perioperative Transesophageal Echocardiography
  • pharmacological and mechanical hemodynamic support,
  • perioperative pain management.
  • hemodynamic and respiratory monitoring
  • management of cardiopulmonary bypass
  • perioperative critical care including ventilatory support

Division of Allied and Therapeutic

Physiotherapy includes

• Assertive device provision and user training
• Pre and Post-Operative therapy
• Physical health education on lifestyle and prevention strategies
• Cardiopulmonary rehabilitation
• Post-stroke rehabilitation

Services offered

• OPDs
• ICU
• General Ward
• Cardiac Coronary Unit

Division of Adult Cardiology

• Team Consist of a Senior Consultant Cardiologist, two consultant Cardiologists, and 6 Cardiology fellows
• Interventional Procedures such as:
  • Percutaneous Coronary Interventions
  • balloon mitral and valvuloplasty
  • permanent pacemakers
  • Cardiac Resynchronization Therapy
  • Implantable cardioverter defibrillators implantations

Research is actively done locally and in collaboration with international partners. Current Projects are:

• Rheumatic Heart Disease Registry
• A better understanding of acute rheumatic fever in Uganda study
• AFROSTREP Uganda study
• INVCICTUS trial
• the Peripartum Cardiomyopathy Registry
• the Myocardial Infarction Registry
• cardiac arrhythmias study

The adult Cardiovascular surgery division

Service offered

Out-patient Services

• Aortic aneurysm clinic
• AV- shunt clinic (for hemodialysis).
• cardiac aneurysms
• cardiac tumors
• chronic thromboembolic pulmonary hypertension.
• Coronary surgery clinic
• Grown-Up Congenital Heart disease
• Pericardial disease clinic
• Peripheral vascular surgery (arterial and venous insufficiency)
• Valvular heart disease clinic

In-patient Services

• Aortoiliac aneurysmectomy and repair (open)
• Arterial bypass surgery for peripheral arterial insufficiency.
• AV shunt creation/takedown – Access for hemodialysis in end-stage renal disease
• Cardiac aneurysm repair
• Cardiovascular trauma surgery
• Coronary artery bypass graft surgery
• Excision of cardiac tumors
• Excision of cervical paragangliomas
• Pericardial surgery
• Pulmonary endarterectomy
• Repair of congenital heart defects in GUCH
• TEVAR / EVAR (Endovascular surgery)
• Valve repair and replacement
• Varicose vein ablation/stripping for peripheral venous insufficiency

Uganda Heart Institute Research Areas

• Capacity building
• Disparities in the prevention, diagnosis, or treatment of cardiovascular diseases
• Epidemiology of cardiovascular diseases
• Healthcare systems in the delivery of cardiovascular services
• Natural history, clinical profiles as well as clinical outcomes of cardiovascular diseases
• Prevention, diagnosis, and treatment of cardiovascular diseases

UHI Research Partners

• Case Western Reserve University
• Makerere University
• Mbarara University
• Joint Clinical Research Centre
• Medtronic International
• PASCAR

Training Offered at UHI

1. Cardiac Nursing
2. Adult Cardiology
3. Cardiac Surgery
4. Pediatric Cardiology
5. Cardiac Critical Care
6. Cardiac Anesthesia

• UHI has collaborated with World-Class Hospitals and Universities.
• The training disciplines include
  • Advanced heart failure management and nuclear medicine are going to develop in Uganda.

Partnering Institutions include

• Amrita Institute of Medical Sciences and Research, Kochi, Kerala, India.
• Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio.
• Chain of Hope- UK
• Children’s National Medical Center, Washington DC
• Gift of Life International
• Madras Medical Mission
• McMaster University, Hamilton, Canada.
• Riley’s Children’s Hospital, Indiana USA
• The University of Cape Town

Some major Publication of UHI

• Annual Incidence Rates of Newly Diagnosed Endomyocardial Fibrosis Cases at the UHI
• Secondary Antibiotic Prophylaxis for Latent Rheumatic Heart Disease
• Determining the Risk of Developing Rheumatic Heart Disease Following a Negative Screening Echocardiogram
• The pattern of congenital heart disease among children presenting to the Uganda Heart Institute, Mulago Hospital
• Rheumatic Heart Disease Treatment Cascade in Uganda
• The outcome of patients undergoing open heart surgery at the Uganda heart institute, Mulago hospital complex.
• Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting

Cost of Services at UHI

The services that are been provided at UHI are been subsidized cost to the local population. The service charges can easily obtain from the account departments in outpatient departments. With the current trends, the surgery cost continuously upgrades its services charges and the state-of-art. In collaboration with international partners, they try to provide the best services to their patients at UHI.

If we talk about an average cost of a heart surgery in Uganda are around 5000 USD.  The Cost may vary because it depends on various factors and the surgery your are looking for.

Uganda Heart Institute Review

At UHI the top priority is to provide great services to their patients. The customer’s priority is most. They listen to every patient very actively and try to resolve the problems. The surgeons are the best in UHI. They are very skilled and knowledgeable people. A full-fledged hospital is where a patient can get everything as per their needs. From consultation to the surgical procedure they perform every step very efficiently and smoothly. The operating surgeons also discuss every aspect of the surgery and what they expect from the treatment and try to deliver that to the patients. Affordable charges with the extra facility are also provided. Clean and Hygienic environment. UHI is one stop for any cardiac surgery in Uganda.