Welcome to the April 2019 edition of Health City Cayman Islands’ newsletter especially for physicians and medical professionals. Here, we will share with you the latest developments at Health City – including new services and procedures, as well as patient stories.
In This Issue
Message from Dr. Devi Shetty
Cardio Vascular and Thoracic Surgery
Pulmonology and Sleep Medicine
Founder, Health City Cayman Islands
Greetings Dear Doctors,
It is with great pride that we release our newsletter which aims to highlight the clinical work we have been performing at Health City Cayman Islands.
It has been five years since we established the facility with the aim to offer high quality and accessible healthcare to the region. Since then, our clinical outcomes and thousands of satisfied patients continue to motivate us to carry on our mission.
Marc Andreessen, founder of Netscape, once said that “Software will eat the world”.
I do believe that software will disrupt our industry as well. Through this process, healthcare will become safer, more affordable and accessible for our patients. Most importantly, it will preserve the joy of caring for patients that we as doctors crave. In the geographically spread-out Caribbean region, software will ensure that the reach of highly trained specialist doctors is not limited by the borders of an island and that the connection of the primary care giver with his/her patient is preserved.
We are in the process of building a technology platform to enable seamless continuity of care and to ensure that the location of a patient does not limit their ability to access required medical care. Doctors will also be able to conveniently access their patients medical records while also being empowered to direct them to the appropriate specialist while continuing to remain as the centre of the care delivery experience.
We, as doctors need to embrace this change in our industry and be at the forefront of its adoption. Let us not end up like the taxi driver wondering where to fit in when Uber arrived.
I would like to thank all the doctors who have played a vital role in our journey so far and I hope that you will enjoy reading through this summary of our clinical achievements and our vision for the future.
The Department of Anesthesiology at Health City provides a range of anesthetic, perioperative, resuscitative and pain management services to local, regional, and international patients of all ages. We are committed to upholding the highest standards of care for our patients and strive to continually improve the services that we offer, including 24-hour on-call emergency coverage.
Anesthesiology is a vital component to providing safe out-of-hours care throughout the hospital responding to emergencies not only in theatre but also in the triage and in the wards. All of our anesthesiologists, intensivists, critical care nurses, physical therapists and anesthesia technologists are certified ACLS (Advanced Cardiac Life Support ) providers. Their collective role shadows the patient journey from pre-assessment, in planning and preparing for surgery, through to the safe delivery of anesthesia for the procedure and postoperatively in the critical care unit, (Post Anesthesia Care Unit) recovery room, or in the ward during the post-operative visit to ensure full recovery and adequate pain relief.
Anesthesiology department provides:
- Anesthetic care in the operating rooms, Scopy suite, Radiology Suite & Hybrid Cathlab for all types of surgical, diagnostic and therapeutic procedures including CTVS-adult and pediatrics,Bariatric, neurosurgery, interventional neurology, Orthopedics, Plastic surgery, Urology, etc.
- Pre-operative and post-operative pain management with:
- Epidural Analgesia & Paravertebral Analgesia Patient Controlled Analgesia
- Ultrasound Guided Regional Nerve Blocks
- Continuous Peripheral Nerve Block Techniques (Brachial Plexus block, Adductor canal block, Femoral nerve block,TAP block, Paravertebral block, etc.)
SPECIALISED ELECTROPHYSIOLOGY CLINICS
Device Optimisation Clinic
Physicians and nurses in the clinic evaluate and manage the care of patients prior to, and following, the implantation of cardiac pacemakers, automatic internal cardioverter defibrillator systems, CRT devices, LVAD and after loop recorders. We work together to optimise the device to each patients’ needs and to help our patients embrace their new lifestyle.
Health City are also planning a remote monitoring facility.
Our Syncope Clinic offers a comprehensive diagnostic and management strategy for patients suffering from brief losses of consciousness.
Heart Failure Clinic
At the Heart Failure Clinic, specialists in the diagnosis and treatment of heart failure care for patients using various medical and interventional modalities.
Our goal is to reduce hospitalisations and improve the quality of life of our patients.
Health City’s Electrophysiology division is actively pursuing the following epidemiologic studies, which will soon extend across the Caribbean.
CAFÉ - Cayman AF in elderly study
CASH - Cayman athlete screening for heart disease
Electrophysiology is a division of cardiology dealing with patients experiencing fast, slow or irregular heartbeats. These are known as cardiac arrhythmias.
We offer an exceptional arrhythmia management service, the only one of its kind in the Caribbean, in order to provide cost effective solutions to patients.
Our state-of-the-art Electrophysiology lab includes the latest generation 2D and 3D mapping systems, an RF generator with cooled flow RF compatibility and the latest Cryoablation console. This technology is housed in an advanced hybrid lab, complete with EP Navigator technology to ensure safe and effective procedures.
- We offer a comprehensive device implantation program at Health City, including:
- Pacemaker implantation
- Implantable cardioverter defibrillator implantations (ICD)
- CRT implantation for heart failure
- Implantation of CCM (Cardiac Contractility Modulation) device in heart failure
- Loop recorder insertion
- LA appendage closure device implantation
ABLATION OF CARDIAC ARRHYTHMIAS
Ablation of PSVT, including WPW syndromes across all age groups
Ablation of ventricular tachycardia, including epicardial mapping
Ablation of atrial fibrillation using radiofrequency or Cryo balloon*
*Cryo balloon ablation is a relatively new technology, destroying arrhythmia generating tissues though freezing.
We specialise in the extraction of leads from inside the heart and are among a handful of facilities in the Caribbean with a capability and certification to do so.
We also offer a fully equipped, non-invasive arrhythmia management facility, ensuring proper medical management of our patients.
Services offered include:
- 2D/3D Echocardiography
- Stress test
- Ambulatory BP monitoring
- Digital holter monitoring
- Event recorder
- Tilt Table testing
Interpreting complex arrhythmias and troubleshooting issues related to ECGs is not an easy task. This is why we offer free arrhythmia consultations, so patients can deal directly with our Electrophysiologist and discuss any questions which may arise.
Interpretation services are offered by our tele-medicine unit, allowing patients to speak with their doctors without having to travel.
We offer a fully equipped non-invasive arrhythmia management facility allowing for proper medical management of our patients, offering services such as:
- 2D/3D Echocardiography
- Stress test
- Ambulatory BP monitoring
- Digital holter monitoring
- Event recorder
- Tilt Table testing
- Arrhythmia interpretation services
Specialised Electrophysiology Clinics
We offer a full scope of specialised clinics to provide for the needs of our patients, including:
- Device optimisation clinic
- Syncope clinic
- Heart failure clinic
- Atrial fibrillation clinic
Our team of nurses and doctors are committed to providing quality care and service within the Interventional Cardiology Department. Common conditions we treat and offer procedures for include:
- Valvular heart disease
- Coronary artery disease
- Peripheral artery disease
- Resistant hypertension
- Aortic disease
Electrophysiology is the subdivision of cardiology dealing with patients having cardiac arrhythmias (fast, slow or irregular heartbeats). We offer an exceptional arrhythmia management service - the only one of its kind in the Caribbean - providing cost effective solutions to patients with such problems.
Our state-of-the-art technology allows safe and effective performance for the following procedures:
- Ablation of PSVT/ WPW syndrome
- Ablation of atrial fibrillation (AF)
- Ablation of ischemic and normal heart ventricular tachycardia
- Epicardial mapping of ventricular tachycardia
- Device therapy (pacemaker / defibrillator implants (ICD)/ Cardiac resynchronisation therapy (CRT)
- Implantation of loop recorder in patients with Syncope
- Cardioversion of persistent AF
- Lead extraction of pacing and defibrillator leads
Adult Heart Surgery
- Coronary Artery Bypass Surgery (CABG)- including high risk Coronary Artery Bypass Surgery,
- Off Pump Bypass Surgery
- Minimal access CABG
- Aorta and Aortic Valve Surgery
- Minimally Invasive Mitral Valve Repair
- Mitral Valve Repair and replacement
- Surgery for Infective Endocarditis
- Tricuspid Valve Surgery
- Minimally Invasive Heart Surgery
- Surgical treatment for Atrial Fibrillation (Maze Procedure and Modified Maze procedure)
- Surgical Procedures to Treat Heart Failure
- Left Ventricular Assist Devices
- Surgery for Aorta Surgery, Marfan Syndrome, and Connective Tissue Disorders
- Complex Aorta Surgery
- Surgery for Hypertrophic Cardiomyopathy
- Surgery for Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
- Adult Congenital Heart Surgery
- Vascular interventions - Endovascular procedures and hybrid procedures for complex aortic aneurysms and dissections
- Extra Corporeal Membrane Oxygenation (ECMO)- for cardiac and respiratory failure
Pediatric Heart Surgery
All forms of simple and complex congenital heart conditions in neonates and children. This includes :
- Atrial septal defect
- Ventricular septal defects
- Tetralogy of Fallot
- Double outlet right ventricle
- Partial and total anomalous pulmonary venous connections
- Atrio Ventricular Canal Defects
- Transposition of Great Arteries
- Truncus Arteriosus
- Coarctation of Aorta
- Tricuspid Atresia
- Single ventricle repairs
- Hypoplastic Left Heart Syndrome
- Congenital Valvular Heart Diseases
- Coronary artery fistula
- Heart Tumours
- Pediatric ECMO implantation for various conditions
All forms of lung resections and surgery for pleural and mediastinal diseases.
The department of Dentistry in Health City has been operational since 2016 and has been providing wide range of dental treatments.
Scope of Services:
- Deep Cleaning
- Crown lengthening
Restorative and Endodontics
- All kinds of filling
- Root canals both anterior and posterior teeth
- Post and Core
- Wide range of pediatric procedures
- General anesthesia and local anesthesia based
- Removable partial dentures
- Complete Dentures
- Extractions of all kinds except complicated/impacted wisdom tooth
- Composite Direct Veneers,
- Facial Botox injections
- Tooth Jewelry
Some of the cosmetic restorations done:
Staffing: One medical oncologist, two oncology nurses.
Facility: Dedicated daycare unit with 4 chairs and one bed
Focus: Affordable, compassionate care in a multidisciplinary setting.
- Cancer Risk Assessment and Screening
- breast, cervical, colorectal, prostate, and lung cancers
- Diagnostic and Therapeutic Procedures
- Biopsies of solid tumors or lymph nodes, bone marrow aspiration and biopsy, CT or USG guided biopsies
- Tc99m Bone scan, paracentesis, thoracocentesis
- Chemotherapy, Immunotherapy and targeted therapy of various solid tumors, lymphomas and chronic leukemias in adults
- Supportive Care
- Pain management, palliative care, prevention and treatment of cancer-related infections, transfusions and survivorship counseling, dietetics, physiotherapy.
- Referrals and coordination of multidisciplinary care: Includes multidisciplinary care planning with our surgeons and appropriate and timely overseas referrals for services not presently available at Health City, including Radiation oncology, Robotic surgery and PET CT scan.
Neurosurgical services at Health City Cayman Islands were initiated in September 2015. The department of Neurosurgery offers basic and advanced neurosurgical services, covering a wide spectrum of brain, spine and peripheral nerve disorders.
Dr. Susheel Wadhwa, Consultant Neurosurgeon & Spine Surgeon
Dr. Manjunath Kandala, Jr. Consultant Neurosurgeon & Spine Surgeon
Dr. Komal Prasad, Visiting Neurosurgeon & Spine Surgeon
- Neuro Navigation
- High end operating microscope
- C-arm fluoroscopy
- Pneumatic drill system
- Programmable CSF shunt system
- 200 surgeries until June 2018
- First Brain Aneurysm clipping on island
- First awake brain surgery in the region
- 0% surgical site infection
- 0% direct surgical mortality, <1% major permanent morbidity
- Brain tumors - Gliomas, meningiomas etc (supratentorial, infratentorial, skull base)
- Hydrocephalus - congenital, adult, obstructive, normal pressure hydrocephalus
- Trauma - Acute and chronic. Including calvarial and skull base reconstruction
- Cerebrovascular Surgery - aneurysms, AVM, cavernomas
- Brain Haemorrhage - extradural, sub dural, hypertensive, sub arachnoid hemorrhage
- Decompressive craniectomy for stroke
- Functional surgery - trigeminal / glossopharyngeal neuralgia
- Degenerative disc disease - cervical, thoracic and lumbar
- Fusion - Cranio vertebral junction, cervical, thoracic and lumbar (anterior & Posterior)
- Minimally invasive surgery - Lumbar discectomy and fusion, cervical discectomy
- Spinal tumor - vertebral, extradural, intradural, intramedullary
- Spinal infections - tubercular, osteomyelitis
- Trauma - cervical, thoracic, lumbar
- Cervical disc replacement
- Congenital anomalies - tethered cord, split cord, myelomeningocoele, dermal sinus
Peripheral Nerve Surgery
- Peripheral nerve tumors
- Carpal tunnel surgery
- Traumatic nerve injury (limited)
- Nerve biopsy
- Wide range of Neurosurgical services - 24 x 7
- Full time/ in-house Neuro intervention services & Dept of Neurology
- Neuro anaesthesia and intensive care facilities
- Advanced diagnostic support services - MRI, CT scan and CT angio, EMG, EEG, NCS
- Post op Physical Rehabilitation services
- Experienced Neurosurgical OR staff
- Neuro Navigation guided surgery
PULMONOLOGY OUTPATIENT SERVICES INCLUDE:
Diagnosis and Management of:
- Interstitial Lung Diseases
- Pulmonary Hypertension
- Lung Cancer diagnosis and staging
- Evaluation of Pulmonary nodules
- Pleural diseases diagnosis and management
- Tuberculosis/ atypical infections
- DVT/ PTE management
- Pneumoconiosis eg. Asbestosis
PULMONOLOGY IN-PATIENT SERVICES INCLUDE:
Diagnosis, management and interventions for:
- Pneumonia/ Lung abscess
- COPD exacerbations
- Asthma exacerbations
- Acute exacerbations of interstitial lung disease
- Respiratory failure- Type 1/ Type 2
- OSA/ Obesity hypoventilation syndrome
- Pneumothorax/ Pleural effusion/ Empyema management
- Malignant pleural effusion
- DVT/ PTE management
SLEEP MEDICINE SERVICES INCLUDE:
- Sleep medicine consults and follow-ups
- In- lab sleep studies: Diagnostic/ Split Night/ PAP titrations.
- Home sleep studies- Level 2, 3 and 4.
- MSLT/ MWT
- Nocturnal Oximetry
- Management of Sleep apnea, insomnia, narcolepsy, Periodic limb movement disorders
DIAGNOSTIC SERVICES OFFERED:
- 6 minute walk test
- Exercise challenge test
- Diagnostic Flexible bronchoscopy- Bronchial lavage, TBNA, TBLB, Endo-bronchial biopsy.
- CT guided lung / pleural biopsies.
Caring for people who are seriously ill has become a large and complex part of health care and requires many specialist skills to ensure we provide the best possible care for some of our most sickest and vulnerable patients.
The development of a 20-bedded centralized unit, caring for any patient in the hospital who needs a higher, more specialized level of care, will enable our clinical teams to improve patient safety and incorporates both surgical, general (medical) and HDU beds in one place.
Having critically ill patients cared for in one area by highly trained specialist nurses and resident doctors immediately available has been shown to save lives, as well as improving the quality of patient care and the whole patient experience. At HCCI, we have 1:1 nursing ratio for level 3 care and 1:2 ratio for level 2 care.
There are 24 intensive care beds (level three) at Health City Cayman Islands and 4 high dependency beds (level two).
The intensive care unit (ICU) at Health City Cayman Islands is situated on the ground floor across the theatre complex.
The ICUs are named Medical intensive care (MICU, 10 adult beds) and Surgical intensive care (SICU, 10 adult/paediatric beds), Post anaesthesia recovery unit (4adult/pediatric beds). We are the regional referral centre for cardiology, cardiovascular thoracic surgery, ECMO services, Pulmonology, orthopaedics and trauma, interventional neurology and acute stroke services, neurosurgery, bariatric surgery and GI surgery.
Intensive care at Health city has state of art facilities that can support the critically ill. This includes 4 negative pressure isolations and 4 positive pressure isolation rooms, advanced hemodynamics monitoring systems( PICCO, Vigelio, CCO), advanced ventilators, IABP, ECMO, Continuous Renal replacement therapy, plasmapheresis, plasma exchange, EEG, TEE, bronchoscopy, ultrasound along with other point of care assessment devices.
We have a team of highly trained 16 intensive care consultants caring for the needs of the critically ill. The critical care team also oversees the care of critically ill patients in the high dependency unit. Dr Mahantesh Patil MD, FCCM, FICM, EDIC. is the clinical lead for intensive care and acute care services at HCCI and can be contacted at [email protected] .
Emergency room is the gateway to any hospital and acts as an interface between outpatient and inpatient admissions. Emergencies are often stressful conditions and we take utmost care to ensure your visit to emergency room is quick and smooth as possible.
The emergency room in Health city Cayman has 6 beds with 2 resuscitation beds and 4 acute care beds with an attached operation theatre.
Emergency room is situated on ground floor with direct access to resuscitation bay for Ambulance.
ER is manned by 5 consultant physicians, 4 registrars and trained staff.
Emergency is equipped with state of the art equipment for a wide spectrum of patients with acute emergencies for initial evaluation, resuscitation, treatment, investigation, stabilization, monitoring and disposition. It is equipped with cardiac monitors, defibrillator, mechanical ventilator, transport ventilator, syringe pumps, oxygen therapy unit, suction machines, airway management devices along with difficult airway management devices, ETCO2 monitors, ABG machine, bed side ultrasound machine.
It is backed by surgical and medical ICU for continued care.
Round the the clock laboratory services, blood bank support and radiological services like ultrasound, CT and MRI aids in diagnosis and management of critically ill, helping us emergency ready 24/7.
Diagnostic testing is an integral part of the healthcare equation. Almost nothing happens, whether diagnosing a disease or monitoring a therapy, without a laboratory test.
We provide a high quality diagnostic and consultative services to clinical users of Health City Cayman Islands and to primary and secondary care providers in the locality. A team of pathologist, microbiologist and medical technologist work round the clock to offer various services. All the Quality assurance is followed according to JCI guidelines.
We have well equipped State-of-art autoanalysers with lab interfacing and integrated system for analysis of patient samples. We have a multitude of specialty departments.
- Clinical Pathology
- Blood bank
The biochemistry department offers a broad spectrum of tests for the diagnosis and monitoring of disease, and response to therapy.
These will measure levels of specific chemical components of body fluids required to assess or monitor the function/dysfunction of organs such as the heart, kidney, liver, thyroid etc.
Tests include blood glucose, electrolytes, enzymes, hormones, lipids (fats), tumor markers, other metabolic substances, and proteins. These tests are performed using fully automated and sophisticated equipment, able to handle high volumes, and make results available within a very short turnaround time.
The Hematology laboratory is based within the current facility at HCCI. Following are the tests which are done in house.
Full blood counts with retic count and blood films( Peripheral smear examination),Bone marrow smear preparation and evaluation.
Coagulation screens which include PT, APTT, D dimer, Fibrinogen and factor assays.
The microbiology department deals with the culturing, isolation and identification of micro-organisms such as bacteria and fungi obtained from various parts of the body using various specimens including swabs from wounds and pus, feces, urine, respiratory specimens and blood and cerebrospinal fluid.
This includes all routine Urine analysis and body fluid analysis.
We have the facility for Examining Pap smears with advanced technology with Thin layer cytology. Fine needle aspiration cytology and cytospin are also available.
The Health City Blood Bank and transfusion services department provides efficient services. Major users of the services are cardiac surgery, neurosurgery, general surgery, orthopedics and oncology which requires the blood components like PRBCs( Packed Red Cells ), FFP( Fresh Frozen Plasma ) and SDPs( Single Donor Platelets ).The SDPs are collected by sophisticated Cell separator named as Trima accel and the products are treated by Mirasol reduction technology wherein the product is made free of pathogens. The other products like PRBCs and FFP are supplied by George Town Hospital. Minimal stock of O positive and O negative are maintained in the blood bank to cater the emergency needs. The quality assurance is in conformance with CRS and PAHO guidelines.
Learn More About Health City's Laboratory Services
Department of Neurology and Interventional neurology
The Department of Neurology and Interventional Neurology was set up in 2016. It is a state of the art department offering both general neurology services as well as interventional neurology services for people in the Caribbean and surrounding regions. The department has specialized clinics such as stroke clinics, migraine clinics, Multiple Sclerosis Clinics and movement disorder clinics.
Some of the services offered are:
General Neurology Services
- Cerebrovascular disease, such as stroke
- Demyelinating diseases of the central nervous system, such as multiple sclerosis
- Peripheral Demyelinating disorders- Gillian Barre Syndrome
- Neuromuscular disorders, such as myasthenia gravis
- Peripheral neuropathies
- Headache disorders
- Meningitis, encephalitis and other CNS infections
- Movement disorders, such as Parkinson's disease
- Neurodegenerative disorders, such as Alzheimer's disease and Amyotrophic Lateral Sclerosis (Lou Gehrig's disease)
- Seizure disorders, such as epilepsy
- Spinal cord disorders
- Diagnostic Cerebral and Spinal Angiogram
- Endovascular Treatment for Stroke
- Carotid Artery Stenting
- Aneurysms- Coiling and flow diverter stenting
- Arteriovenous Malformations (AVM / DAVF)- embolization
- Tumor Embolization- pre operative
- EEG (electroencephalogram) both long (overnight, 24 hours, 48 hours and 72 hours) and short term regular and video EEG
- Evoked Potentials -Visual Evoked Potentials (VEP), Brainstem Auditory Evoked Potential (BAER), Somatosensory Evoked Potential (SSEP)
- Nerve Conduction Study (NCS)
- Electromyography (EMG)
The Department of Orthopaedic Surgery cares for all injuries and diseases of the musculoskeletal system. Our subspecialties include joint replacement/reconstruction, sports medicine, trauma, foot and ankle, hand and upper extremity, pediatric orthopaedics, orthopaedic oncology, and rehabilitation.
Our multidisciplinary approach, linking the expertise of specialists in orthopaedic surgery, reconstructive plastic surgery, radiology, anesthesia, physical therapy, and orthopaedic nursing, ensures that each patient receives comprehensive care for his or her condition.
Health city Cayman Islands is the only center in to offer totally computer navigated knee replacements. About 500+ joint replacements surgeries (Hip, Knee, Shoulder & Ankle) which include 15 complex revision joint replacements. We also specialize in the Direct Anterior Approach (minimally invasive hip replacement). We have one dedicated orthopaedic operating room for Joint replacement surgeries with laminar air flow and computer navigation setup.
Our other achievements include Limb lengthening (magnetic nail) – First Magnetic nail for femoral lengthening in the Caribbean.
We have completed 1000+ surgeries over the last 4 years and still counting. At the end of each day all of us can say – we made a difference in at least one person’s life.
Learn More About Health City's Orthopedics Services
Our expert pediatric cardiologist and experienced support staff are here to help our cardiac patients, from newborn infants to young adults. Our specialists diagnose and treat heart and blood vessel disease in children. This includes Congenital Heart Disease in children, adolescents and adults and Acquired and functional heart disease in children. We utilize specialized equipment to evaluate and treat cardiac conditions that deliver the least invasive and most efficient methods of treatment possible. We have treated more than more than 400 children, adolescents and adults with congenital and acquired structural heart disease of which about 100 are done by percutaneous(Minimally inavisive) intervention with excellent outcome.
NON INVASIVE PEDIATRIC CARDIOLOGY
- We use cutting-edge technology in the diagnosis of congenital and acquired heart disease in children and adolescents:
- ECG/Holter monitoring
- Transthoracic echocardiogram
- Contrast echocardiogram
- 3D transesophageal echocardiogram
- Tissue doppler echocardiography
- 128 slice cardiac CT angiography
- Cardiac MRI
- Exercise stress test
- Tilt table test
INTERVENTIONAL CARDIOLOGY PROGRAM
Non-surgical treatment of Congenital Heart Disease has evolved rapidly over the past decade. This involves treating certain defects like Atrial Septal Defect (ASD) and Patent Ductus Arteriosus (PDA) through a pinhole in the groin. This is done under fluoroscopic guidance in Health City’s state-ofthe-art Hybrid Catheterization Laboratory. Patients are usually discharged the next day after the procedure without a scar.
I. DEVICE IMPLANTATION PROGRAM We offer minimally invasive procedures for the closure of the following via special devices:
- VSD, Muscular
- VSD, Perimembranous
- Coronary fistula
- Pulmonary AV fistula
- PDA can be closed in babies as small as 3.5kgs and ASD in babies as small as 10kgs
II. BALLOON VALVULOPLASTY AND STENTING
- Balloon Pulmonary Valvuloplasty
- Balloon Aortic Valvuloplasty
- Balloon Mitral Valvuloplasty
- Coarctation Stenting
- Pulmonary Artery Stenting
- Balloon atrial septostomy
- PDA stenting
- MAPCA Coiling
ADULT CONGENITAL STRUCTURAL HEART DISEASE PROGRAM
Medical advances have created a large and growing population of adults who were diagnosed with congenital conditions as children and now require specialized cardiac care as adults. We have a team of experts, including specialists in anesthesiology, cardiology, cardiovascular surgery, cardiac catheterization and electrophysiology, who are specially trained in the complex anatomy and heart function of adults with congenital heart disease. Some of the complex procedures performed include:
- Percutaneous pulmonary valve replacement (MELODY
- Stent placement in pulmonary artery and aorta
- PFO and ASD device closure
- Re-do open heart surgeries and valve/conduit replacement
- Paravalvular leak device closure
PATENT FORAMEN OVALE (PFO) DEVICE CLOSURE PROGRAM FOR CRYPTOGENIC STROKE
Our expert team of cardiologists and neurologists evaluate and manage stroke patients below the age of 60. PFO Device Closure could be an option for those patients.
PULMONARY HYPERTENSION CLINIC
Our pulmonary hypertension clinic evaluates and treats infants, children and adolescents with pulmonary artery hypertension, or elevated blood pressure in the lungs.
SYNCOPE AND ARRHYTHMIA CLINIC
Our experienced team are experts in the diagnosis and management of syncope and arrhythmias. Our expertise includes:
- Exercise stress test
- Holter monitoring
- Electrophysiological study
- Radiofrequency ablation
- Cardiac pacemaker implantation
- Temporary pacemaker
- Implantable loop recorder
HEART FAILURE PROGRAM
For children with congenital disorders, cardiomyopathy, neuromuscular disorders and other conditions that lead to heart failure, we offer expert diagnosis and treatment, including ECMO.
Our experienced surgical team has performed corrective and palliative surgeries for simple and complex congenital and acquired heart conditions in infants, children, adolescents and adults, including Tetralogy of Fallot, TAPVC, TGA, DORV, AV canal defect, valve repair and replacement.
Learn More About Health City's Pediatric Cardiology Services
Endocrine disorders can affect how your child is growing and developing. They can also contribute to the development of diabetes. The Endocrinology Program at Health City Cayman Islands is a multi-disciplinary program dedicated to the care of infants, children, adolescents and young adults with a wide range of endocrinological disorders.The division offers expertise in all areas of pediatric endocrinology, including disorders of growth, puberty, sex differentiation, glucose metabolism, bone and mineral metabolism, the pituitary/hypothalamus, the thyroid, the adrenal and the gonads. Our goal is to provide personalised care of the highest quality to all children & adolescents seeking our advice. We also provide specialised diagnostic endocrine tests for patients in areas of endocrinology.
Since June 2017, Health City has been offering paediatric allergy services. This service is run by Dr Shyla. Dr Shyla is a general paediatrician with over 30 years’ experience who has a Masters in Allergy from Imperial College, London. This enables her to offer a comprehensive testing and advisory service for a range of paediatric allergies.
Dr Shyla works closely with Dr Archita, Consultant Pulmonologist to optimise the testing and management of children with bronchial asthma.
Atopy refers to the genetic tendency to develop allergic diseases such as allergic rhinitis or hay fever, food allergy, asthma and atopic dermatitis (eczema).
This is typically associated with an increased immune response to common allergens, especially inhaled allergens like grass, and food allergens like nuts.
Over the past 50 years, the world has seen a huge increase in allergies whether it's due to the way we live, the food we eat, our environment or a combination of all of these. Globally, 220-250 million may suffer from food allergy alone. The incidence of food allergy is estimated at 5-8% in children and 1-2% in adults. In addition to this, global rates of asthma, eczema and hay fever continue to rise.
These must not be confused with intolerances or hypersensitivity which are not immune mediated. Intolerances and hypersensitivities do not have specific tests. They are usually diagnosed with the combination of a detailed history and supervised elimination diets.
For the immediate type of food allergies, and inhalant allergies causing asthma and hay fever, we now offer reliable testing with blood tests, spirometry (to check lung function) and skin prick testing. Skin prick testing is particularly useful as it gives quick results. As part of our service, we also check the use of inhaler devices, adrenaline auto injectors and nasal sprays. We are able demonstrate the ideal techniques for these. After testing and diagnosis, patients receive an allergy action plan to be used at home and at school.
Accurate detection is vital to the timely treatment of disease. Health City Cayman Islands performs a full range of diagnostic imaging and radiology services to facilitate primary diagnoses, early intervention, fluoroscopy to obtain real-time moving images of a patientâ€™s internal structures, disease treatment progress, pre-surgical testing and post-surgery reviews. These advanced medical imaging technologies, including Doppler imaging ultrasound, and radiology services are applied for inpatient testing, as well as the evaluation of outpatientsâ€™ tests and to support emergency departments. Emergency radiology services are available at Health City Cayman Islands 24 hours a day, seven days a week.
Health City Cayman Island's Diagnostic Radiology Department is staffed by experienced radiologists and support staff serving in a patient-friendly environment equipped with the most advanced technologies. Through our adherence to the IMAGE GENTLY and ALARA standards, we are able to limit radiation exposure, while producing high quality images that support accurate diagnoses.
Following is a list of the radiology services and medical laboratory diagnostics provided by Health City Cayman Islands:
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
- Digital radiography
- Nuclear medicine
- Diagnostic Ultrasound
- Vascular ultrasound Doppler studies
- BMD scan for bone density
- First Centre in the Cayman islands and one the very few centers in the Caribbean to do cardiac MRI, fetal MRI, CSF flow studies and many more.
- Only center in the Cayman islands and one of the only few centers in the Caribbean to have 128 slice CT.
- One of the few centers in the region to do image guided liver biopsy, lung biopsy, fnac of various organs.
- Use of novel cardiac MRI techniques and computational modeling for the quantitative assessment of ventricular performance .
- Advanced hepatic imaging, including multi-detector CT, CT cholangiography, new hepatobiliary MR contrast agents, and MRcholangiopancreatography.
- Dynamic contrast-enhanced MRI and CT for assessment of solid organs and tumors in the abdomen and pelvis
- 3D rendering of CT and MR images, including projectional and volumetric applications, and CT colonography
- Utility of gadolinium MR myelography to detect CSF leaks. Prenatal diagnosis of CNS anomalies with ultrasound and MRI.
- Fastest TAT and TAR in the region.
- mri compatible anesthesia machine.
- Training of radiology technicians and interns programme.
Health City Cayman Islands offers a wide range of urology services including the most advanced surgical
and treatment techniques.
The Urology department at Health City Cayman Islands utilizes the most modern high-tech, fiber optic
and endoscopic techniques (minimally invasive surgery).
Health City Cayman Islands offers a wide range of urology services to treat conditions of the urinary
tract and male reproductive system, including the kidneys, bladder, testes, penis & urethra, and
Urology services available at Health City include:
Stones: For the treatment of both single and staghorn kidney stones, Health City Cayman Islands offers:
- Laser and ultrasonic intracorporeal lithotripsy
- Percutaneous nephrolithotomy(PCNL)
- Retrograde intravrenal surgery (RIRS)
Tumors: Both benign and malignant tumors are treated at Health City Cayman Islands via:
- Radical nephrectomy (Laparoscopic and Open)
- Partial nephrectomy (nephron sparing surgery)
Congenital kidney disorders are treated by:
- PUJO: open and laparoscopic pyeloplasty
- Non-functioning kidney (NFK): simple nephrectomy
- Horseshoe kidney with stones: PCNL, RIRS
- URS – rigid and flexi ureterorenoscopy
- Radical Nephroureterectomy and bladder cuff extension
- Primary obstructive mega ureter (POM); Retrocaval ureter;
- Infection: UTI and Recurrent UTIs
- Stones: Cystoltholapaxy
- PCCL( Per cutaneous cystolithotomy
- TURBT: trans urethral resection of bladder tumor
- Radical cystectomy & ileal conduit
- Radical cystectomy and orthotopic neo bladder construction
- Urinary Incontinence
- RPLND: Retro peritoneal lymph node dissection
- Undescended testes
PENIS & URETHRA
- EIU: endoscopic internal urethrotomy
- Buccal mucosal graft Substitution urethroplasty
- Partial and total penectomy
- Ilio Inguinal lymph node dissection
- PH: Benign Prostatic Hyperplasia/Benign enlargement of the prostate (BEP)
- TURP: Transurethral resection of the prostate
- HOLEP: Holmium laser enucleation of the prostate
- Prostate Cancer
- Radical Prostatectomy
- Treatment of prostate abscess
- Treatment of prostate inflammation
- Sling Procedure for stress incontinence
- TVT – Tension Free Transvaginal Tape procedure for urinary incontinence
- TOT – Transobturator Tape procedure for urinary incontinence
- Cystocele Repair for prolapsed bladder
- Prolapsed pelvis treatment
- Treatment of stones and obstructions of the kidneys, ureter, and bladder using endoscopic
optical instruments and other tools
- Urodynamics (cystometrogram)
- Prostate Cancer Screening: Digital rectal exam
- PSA: Prostatic Specific Antigen
- Trans rectal ultrasound biopsy (12 core)
- MRI of the pelvis (for cancer of the prostate)
- CT Abdomen and pelvis (genitourinary tumors)
- CT urogram (urolithiasis- stone disease)
- Intravenous pylography/urography (IVP)
- Retrograde urethrogram (RGU) (for stricture of the urethra)
- Voiding cystourethrogram (VCUG) (for urethra stricture)
- Ultrasound KUB (kidney, ureter, bladder) – screening for stones, hydronephrosis, renal/bladder
- tumors prostatomegaly, post-void residual urine
General surgery and G I surgery
The Department of General Surgery and Gastrointestinal Surgery offers a range of surgical procedures, including:
- Hernia, including Inguinal, Femoral, umbilical and incisional hernia via laparoscopic and open techniques
- Laparoscopic Surgery for gall bladder and bile duct stones
- Laparoscopic Fundoplication for GERD and reflux
- Gastric & Duodenal Ulcer surgeries
- Gastric cancer surgery
- Thyroid surgery
- Breast surgery for cancer and benign conditions
- Wound management- Diabetes infections, debridements and vacuum wound management systems
- Varicose veins
- Skin lesions
- 24/7 Emergency surgery
We offer a comprehensive service for obesity and weight control for patients with mild obesity (BMI between 30 and 40) we offer a non-operative treatment with an intra-gastric balloon and strict diet control.
For morbid obesity ( BMI > 40) patients will undergo strict diet control; psychological evaluation, cardiac and respiratory assessment and will be offered surgery, including:
- Laparoscopic Sleeve Gastrectomy or Laparoscopic Gastric Bypass.
The treatment will include all these assessments and have a comprehensive follow up to ensure that the weight loss is sustained and patients do not fall back to gaining weight.
We offer minimally invasive colorectal surgery, and a range of services including:
- Laparoscopic operations for benign and cancer surgery
- Right Hemicolectomy
- Left Hemicolectomy
- Anterior Resection
- Abdominal Perineal Resection (with ELAPE and standard APR)
- Colovesical and colovaginal fistula surgery
- Stoma surgery and complex fistula surgery
- Repair for stoma problems
- Complex fistulas and intestinal failure
- Enhanced Recovery Programme for better and faster post op recovery
Surgery for inflammatory bowel disease like totally laparoscopic restorative proctocolectomy
- Surgery for liver cysts and hemangiomas both laparoscopic and open resection
- Treatment of Malignant liver tumours
- Surgery for liver secondaries
- Surgery for hilar cholangiocarcinoma
- Laparoscopic excision of choledochal cyst
- Surgery for cystic tumours of the pancreas
- Pancreatic resection for pancreatic cancers
- Laparoscopic resections of pancreas
- Treatment for endocrine tumours of the pancreas like insulinoma etc
- Minimally invasive esophagectomy for cancer of esophagus
- Thoracoscopic surgery for benign esophageal diseases
- Laparoscopic vagotomy anf GJ
- Laparoscopic treatment for Achalasia Cardia
Upper GI endoscopy
- Screening for cancer and for Baretts Oesophagitis
- Therapeutic endoscopy for Gastrointestinal bleeding
- Stenting for oesophageal cancers
- Dilatation of strictures of the oesophagus
ERCP- Endoscopic Retrograde Cholangio Pracreaticography
To treat gall stones and problems with the biliary tract
- Screening for Cancer
- Evaluation and treatment of polyps and precancerous conditions
- Advanced procedures for polyp and tumour removal
- Stenting for cancer- bridging for surgery and for palliation
- Evaluation of Inflammatory Bowel Disease- Crohn’s and Ulcerative colitis
- Treatment of haemorrhoids- banding
Pelvic Floor Surgery
Haemorrhoids : treatment with Transanal Haemorrhoidal Artery dearterialisation (Halo/Digihal)
This is a relatively painless procedure for treatment of haemorrhoids
Prolapse of the rectum: Laparoscopic and perineal repairs