Multan Institute of Cardiology

History

The project of establishing a state of the art tertiary care center for cardiac patients went through various ups and downs in its early days. It was the desire of millions of people living in south Punjab yet was delayed by bureaucracy. In early 2003, Ch Pervaiz Elahi, the honorable Chief Minister of Punjab, took it thee centre as one of his top priority development projects. The seriousness of his resolve manifested itself when he appointed Col. (Ret) Prof M A Cheema as the Project Director of MIC. Prof. M A Cheema is one of the pioneers of cardiac surgery in Pakistan and had previously established Cardiac Surgery in the Mayo Hospital and Punjab Institute of Cardiology Lahore. Under his leadership the project moved forward with great success and its outdoor service started functioning in 2006. The indoor service was also established within less than one year after the formal opening of the outdoor service. Prof. Cheema carefulyl built up the team of clinicians for this young institute. He managed to bring local and expatriate experts in the fields of cardiology, cardiac surgery and anaesthesia who played a vital role in establishing world class services within such a short period of time. The notable personalities who joined the institute as a result of Prof Cheema's motivation included Prof Haider Zaman (Cardiac Surgeon), Dr. Anjum Jalal (Cardiac Surgeon) Dr. Bilal Qureshi (Cardiologist), Dr. Haroon Babar (Cardiologist) and Dr. Rana Altaf Ahmed (Anesthetist). The first open heart surgery was performed on 29 October 2007 and by March 2008 over 50 open heart operations were conducted without any surgical mortality.

After completion of the Project Prof M A Cheema, his successor was Porf Syed Ali Raza Gardezi to assume the responsibilities of the first Executive Director of the institute. Prof. Syed Ali Raza Gardezi is an accomplished cardiologist who came from the respectable Gardezi family of Multan. The institute achieved several mile stones during the tenure of Prof Gardezi. Construction of a Modular Operation Theater Suite was one achievement at a time when the medical Fraternity in Punjab was not convinced of the benefits of modular theaters. He had the support of Dr. Anjum Jalal who pleaded this case with reason and evidence. Modular theaters have become a norm in tertiary care centers since then and even the staunch opponents of this concept have now converted to support the idea.

Prof Rana Altaf Ahmed was appointed as the Chief Executive after the retirement of Prof Gardezi. Prof. Rana Altaf is a well-known figure in the medical community of Multan. He made enormous contributions in the formative days of the institute. In 2007 he was working in Riyadh when the institute was looking for new faculty staff. He came back to serve his own city and also influenced Prof Anjum Jalal, a highly acclaimed cardiac surgeon at King Khalid University Hospital in Riyadh, to come and serve Pakistan. The institute is making rapid progress under the dynamic leadership of Rana Altaf Ahmed.

Infrastructure

MIC is a tertiary care hospital providing comprehensive services of cardiology and cardiac surgery for both adult and congenital heart diseases.It has one of the largest Modular Operation Theater suites in the country. There are five operating rooms with dedicated preparation and scrub areas. The construction of this modular theater complex finished in early 2009 and the first surgery in the new complex was performed in March 2009. The intensive care has a capacity of 20 beds. The hospital has two Cardiac Catheterization Laboratories while the third lab is being installed. The Institute also has facilities of Cardiac CT-scan, Nuclear Cardiology, Exercise Tolerance Testing and Echocardiography.

The building of the hospital is itself an icon of the modern city of Multan.

Department of Anesthesia

The department of anesthesia is working under the Professor of Anesthesia. It has contributed significantly to the field of cardiac anesthesia in very short period of time. While the main area of service is the provision of post operative care to the cardiac surgery patients in the intensive care units (ICU), it also provides anaesthetic services to the whole hospital on a 24 hours basis. The department has ensured that both intensive care units of the hospital are equipped with the latest technology and has maintained the highest standard of anesthesia care. As of result of this, early extubation of patients after surgery is routine and patients on long term ventilation have internationally acceptable rates of mortality and morbidity.

Department of Cardiac Surgery

The department is performing a large number of complicated and complex heart surgeries. On an average over 1300 surgeries are being performed annually. Our excellent Operative and post operative care has made it possible to achieve the nationwide lowest mortality figures.

Different operations being performed routinely at MIC include:

• Coronary artery bypass surgery.

• Valve replacements and repair

• Surgery for aortic dissection and aneurysms.

• Repair of atrial and ventricular septal defects.

• Repair of Fallot’s Tetralogy

• PDA

• Surgery for Coarctation of aorta

• PA banding

• Right Heart bypass in univentricular heart

• Surgery for peripheral artery disease

The department is headed by a professor and has one associate professor and two assistant professors for adult cardiac surgery with two assistant professors for Pediatric Cardiac Surgery. The department is evolving into an entirely independent Pediatric Cardiac Surgery Department in near future.

Department of Cardiology

The cardiology department provides comprehensive diagnostic and therapeutic services to patients with heart diseases. The department has a fully equipped twelve bedded emergency and twenty bedded CCU for critical patients. The department is headed by Professor of cardiology and its faculty consists of one Associate Professor and four Assistant Professors.

The following diagnostic facilities are available:

The Department has two Angiography labs where following procedures are done:

Department of Pediatric Cardiology

Being a highly specialized field, its importance emerges from the high incidence of congenital and acquired disorders found in children. It provides services in all diagnostic and several therapeutic areas. The department consists of two consultant pediatric cardiologists. The department is doing regular cardiac catheterization for congenital lesions and has started transcatheter treatment of suitable congenital disorders like ASD, PDA, pulmonary stenosis and mitral stenosis.

Department of Pathology

The department has modern equipment and provides a complete array of routine and specialized tests.

Department of Radiology

It provides comprehensive diagnostic imaging facilities round the clock. The following tests are routinely done:

The department has facilities of processing digital images which are displayed online.

Dental Section

The primary aim of the dental section is to provide preoperative dental clearance of the patients undergoing valve surgery. However any patient requiring dental treatment is provided this service within the institute saving them the trouble and cost of visiting the Dental Hospital. The Dental clinic is located on the first floor and is run two consultant dental surgeons.

Central Sterilization Supplies Department (CSSD)

CSSD is the latest and one of the best systems installed in Pakistan and ensures completely sterilized surgical instruments and linen used in the operation theatres and the catheterization laboratories.

Laundry

The laundry system of this hospital is of European make and is able to clean and wash bulk of hospital linen. It is one of the best laundries installed in any hospital in Pakistan both in private or public sector.

Library

Text books and international journals for doctors, nurses and paramedics are available here. It remains open till late evening.

Pharmacy

According to the policy of the Government of the Punjab, the hospital pharmacy provides supply of free medicines to the poor patients. For the convenience of paying patients a retail pharmacy is established in the hospital. It provides high quality medicines at lower than market price. It is located on the ground floor opposite the office of the Executive Director. The retail pharmacy is being updated and upgraded to improve service.

Cardiac Surgery Database

The department of cardiac surgery has a state of the art electronic database donated by Dr. Anjum Jalal, one of the developers of the software. The database presently has complete records of over 4000 patients who underwent surgery from 2009 onwards. It retrieves records quickly so is extremely useful in maintaining consistency of follow-ups. The dynamic lookup facility of the database is also helpful in conducting heavyweight research studies. Such database software is extremely costly, usually over 30000 dollars per year. The role of the database has been recognized and appreciated by both the local and international community of cardiac surgeons.

Clinical Performance

Multan institute of cardiology is primarily serving the poor people living in the region of south Punjab. However, due to its convenient geographic location many patients from upper Sindh, Balochistan and Khyber-Pakhtumkha also visit for treatment of heart diseases. In 2012 a total of 103,472 patients visited the Outpatients Department, 1329 patients underwent open heart surgery, 5487 patients had angiographies and 1564 patients underwent PCI. The institute provided free medicines, as per Government policy, to over 203,048 patients.

In 2012 the institute completed 5-years of its indoor services. The data presented in the year book published on this occasion has put the institute among some of the best centers in the world. The charts given below show clinical performance:

Besides such a large number of patients served, the institute has also achieved distinction for performing highly complex interventions and surgical operations. A large number of adult congenital operations have been performed by the team of cardiac surgeons with exceptional results. Complex aortic root replacements have also been performed routinely. Surgical correction of extremely rare conditions (like aorto-ventricular tunnel and ruptured sinus of valsalva) have also been performed with excellent outcomes.

Academic Achievement

The institute always had the best faculty in the country. Prof Haider Zaman, Prof Rana Altaf Ahmed, Prof Ijaz Ahmed, Prof Anjum Jalal and Dr. Haroon Baber are respectable names among the academia of cardiac surgery and cardiology. As a result of the tireless efforts of its faculty, the institute was accredited by the College of Physicians & Surgeons soon after its establishment. It has trained several cardiologists and cardiac surgeons. The academic activities are a regular feature of the institute. Cath. Meetings, Audit Meetings, and GP training programs are on the regular academic calendar of the institute. The institute has hosted several national meetings including the annual meetings of Pakistan Society of Cardiovascular and Thoracic Surgeons as well as Pakistan Hypertension League.

The institute has the honor of establishing a Department of Academic Affairs which is first of its kind in institutes of Cardiology in Pakistan. Prof Anjum Jalal was appointed its first chairman. His academic achievements have been recognized in national and international circles. Being an accomplished author, researcher, medical editor and trainer he had all the skills necessary for the position. He did his best to inspire the interest for research and publications in the young trainees of the institute. Dr. Anjum Jalal left the Institute in April 2013 to join another newly established center in Rawalpindi as Chief Cardiac Surgeons.

Some of the publications done by the doctors of MIC include the following:

The institute also publishes a monthly news letter under the editorship of Dr. Kashif Hashmi.