Welcome to the December 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
General & GI Surgery
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.)
Our renowned physicians perform minimally invasive cardiac procedures that previously would have required heart surgery. Our state-of-the-art Hybrid Catheterization Laboratory enables us to deliver interventional cardiology services that reduce pain and improve recovery. Nearly all (98 percent) of our catheterization procedures use the more advanced radial access technique because it has been proven to be clinically superior to femoral artery access. The vast majority of our patients experience no complications and positive outcomes.
We offer interventional procedures for the following common conditions:
Coronary Artery Disease
Treatments and procedures offered:
- Radial access coronary angiography
- Primary angioplasty in acute myocardial infarction
- Elective angioplasty with DES, BMS or Absorb stents
- Fractional flow reserve (FFR) technology
- Intravascular ultrasound (IVUS)
- Optical coherence tomography (OCT)
Valvular Heart Disease
Treatments and procedures offered:
- Valvuloplasties (mitral and aortic)
- Transcatheter aortic valve implantation (TAVI)
Peripheral Artery Disease
Treatments and procedures offered:
- Peripheral stents
- Renal stents
Treatments and procedures offered:
- Renal Denervation Therapy
Treatments and procedures offered:
- Aortic stent grafts for aneurysms and dissection
- Hybrid surgical procedures for aortic aneurysms
Electrophysiology is the cardiac specialty that treats patients with cardiac arrhythmias (fast, slow, or irregular heartbeats). Our arrhythmia management service is the only one of its kind in the Caribbean, with a fully equipped, non-invasive arrhythmia management facility and specialized clinics. We focus on providing proper medical management to arrhythmia patients, rather than relying on invasive procedures. The medical technology we use includes the latest generation 2D and 3D mapping systems in our state-of-the-art Hybrid Catheterization Laboratory and EP Navigator facility, enabling physicians to visualize cardiac anatomy in 3D.
Our physicians conduct safe and effective arrhythmia treatments and procedures including:
- Finding and mapping arrhythmias
- Radiofrequency (RF) ablation for the following:
- Short circuit arrhythmias including PSVT and Wolff-Parkinson-White (WPW) syndrome.
- Atrial fibrillation
- Ischemic and normal heart ventricular tachycardia
- Epicardial mapping of ventricular tachycardia
- Pacemaker / defibrillator implants (ICD)
- Cardiac resynchronisation therapy (CRT)
- Implantable loop recorder (ILR) in patients with syncope
- Cardioversion of persistent atrial fibrillation
- Extraction of pacemaker and defibrillator leads
- Cryo Ablation for Atrial Fibrillation
- Digital holter monitoring
- Event recorder- EKG or ECG
- Tilt table testing
The following clinics and studies provide treatment and monitoring for patients with implant devices, syncope studies, congestive heart failure, and atrial fibrillation.
Specialized Electrophysiology Clinics
- Device optimization clinic
- Syncope clinic
- Heart failure clinic
- Atrial fibrillation clinic
Study: Cayman Islands Atrial Fibrillation in the Elderly (CAFE)
Health City Cayman Islands is leading a stroke prevention study in the Cayman Islands, the first of its kind in the Caribbean. The study aims to check for the presence of atrial fibrillation in adults age 65 years and older, using pulse palpation technique and recording an EKG/ECG using an iPhone.
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.
Every woman’s healthcare needs are different. Our Gynecology department focusses on providing personalized care plans to meet each woman’s changing needs throughout every stage of her life.
We provide a vast range of services and specialize in minimally invasive surgeries. We also offer open abdominal and vaginal surgeries for various conditions.
- Routine examinations and screenings, including Pap smears, mammogram referrals.
- Contraceptive management- including IUD insert, implan
- Adolescent gynecology
- Chronic pelvic, perineal pain
- Symptom control and disease prevention during perimenopause and menopause.
Evaluation & Management of:
- Sexually Transmitted Diseases
- Urinary Tract Infections
- Polycystic Ovarian Syndrome
- Abnormal uterine bleeding
- Urinary Incontinence
- Ovarian Masses
- Pelvic Organ Prolapse
- Suspected ovarian or endometrial cancers.
Scope of Medical Oncology Services at Health City
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.
The department offers round the clock services for all neurosurgical emergencies including head injury, intracranial bleeds or hemorrhages, strokes and spine trauma.
The department of Neurosurgery at Health City provides care for a variety of cranial disorders. The department boasts cutting edge technology with the use of Neuronavigation, Endoscopy, CUSA and Intraoperative Imaging. This allows for the treatment of a variety of diseases with excellent results and an exemplary safety record.
The various disorders treated include
- Brain Tumors - Giomas, Glioblastomas, Astrocytomas, Meningiomas, Pituitary tumors, Schwannomas, Skull Base Tumors, Pediatric Brain tumors
- Hydrocephalus - congenital hydrocephalus, obstructive hydrocephalus, normal pressure hydrocephalus, benign/idiopathic intracranial hypertension
- Trauma and intracranial bleeding - Cranial fractures, depressed fractures, intracranial hematomas, Skull reconstruction, hypertensive hematomas, subdural hematomas, decompressive craniectomy for stroke.
- Functional Surgery - Temporal lobectomy for Epilepsy, Trigeminal neuralgia, Hemifacial spasm
Future upgrades planned include dedicated neuromonitoring, which will increase the efficiency of the surgery as well as offer unparalleled safety in Neurosurgery.
Health City Cayman Islands is the top choice for spine surgery in the Cayman Islands and other Caribbean Islands. We have also treated patients from mainland United States and Canada and Central America. The focus of all spine surgeries done at Health City is to relieve pain and restore function. This is achieved by sound planning based on clinically relevant details and through preoperative imaging including dynamic imaging to identify subtle spinal instability.
The Neurosurgical team works in close conjunction with physical therapy to promote early recovery and quicker return to normal life.
The department offers treatments of
- Degenerative disc disease - cervical, thoracic and lumbar
- Fusion - Cranio vertebral junction, cervical, thoracic and lumbar (anterior & Posterior)
- Minimally invasive surgery - Lumbar discectomy and fusion
- Spinal tumors - vertebral, extradural, intradural, intramedullary, metastasis
- Spinal infections - tubercular, osteomyelitis
- Trauma - cervical, thoracic, lumbar
- Cervical disc replacement
- Congenital anomalies - tethered cord, split cord, myelomeningocoele, dermal sinus
- Spine Deformity - kyphosis and scoliosis
Pain and Peripheral Nerve
- Image guided spinal injections
- Peripheral nerve tumors and biopsies
- Entrapment syndromes - carpal tunnel, etc.
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.
Health City Cayman Islands’ specialized plastic surgery clinic provides high quality, compassionate care in the areas of esthetic and reconstructive surgery. The use of sophisticated surgical techniques allows us to address concerns related to congenital defects, developmental abnormalities, trauma and a wide range of elective procedures. The services we offer not only enhance or restore patient’s physical appearance, but also improve function and mobility to allow them to recover more quickly and achieve an improved overall quality of life.
Our surgical team has a broad scope of expertise and is able provide services in a variety of subspecialties.
- Reconstructive Hand Surgery
- Treatment of Skin Cancers
- Treatment of Scars and Scar Revision
- Vascular Malformations: Hemangiomas, Port-Wine-Stain, Venous and Lymphatic Malformations
- Breast Reconstruction (implant, flap, free-tissue transfer)
- Reduction Mammoplasty (Breast Reduction)
Head / Neck
- Botulinum Toxin
- Mentoplasty (Chin Augmentation)
- Dermal Fillers
- Blepharoplasty (Eyelid Surgery)
- Chemical Peels
- Lip Augmentation/Enhancement
- Otoplasty (Ear Surgery)
- Rhinoplasty (Nose Surgery)
- Rhytidectomy (Facelift)
- Abdominoplasty (Tummy Tuck)
- Body Lift
- Body-Contouring after Major Weight Loss
- Breast Augmentation (implants and fat transfer)
- Breast Implant Removal
- Mastoplexy (Breast lift with and without augmentation)
- Treatment of Gynecomastia
As part of our mission to provide patient-centered care, we are committed to ensuring that all patients are well informed and have the opportunity to discuss any questions related to their elective procedure. Information related to potential risks and complications, as well as realistic expectations of results, will be discussed with each patient before proceeding with surgery.
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
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