A letter from H. E. Schafer published in the China Post last July bears testimony to progress in the field. Schafer said that shortly after coming to Taiwan with his wife and children in November 1977, he suffered a massive heart attack caused by the blockage of a coronary artery. After an angiocardiogram test indicated open-heart surgery was necessary, and Schafer learned that the survival rate for his type of attack is only 15 percent, his first impulse was to go home, and then on to Houston, Texas, where the world famous Dr. Coolie has a hospital specializing in open-heart surgery. He frankly remarked: "For some reason, we tend to think that doctors' treatment and general service (in Taiwan) could never compare with (as in my case) American hospitals or doctors. Well, I was never so wrong in my life." The surgery in Taiwan which he eventually decided on turned out to be a great success. This should not be such a great surprise, however, since open-heart surgery is now very common in the Republic of China. Surgery is usually undertaken in three types of heart condition: congenital heart disease, rheumatic heart disease and coronary thrombosis. When a doctor examines the heart, he first notes anything the patient reports that indicates the organ is not working properly. Next, the doctor places a stethoscope on the chest over the heart to hear if there is a murmur. In some cases, the doctor uses an electrocardiograph to make a recording of the electrical changes that occur as the heartbeats. Sometimes echocardiography is used to determine such things as the thickness of the heart walls and the size of the heart chambers. The doctor may also use an X-ray machine to make a shadow picture of the heart. Using a fluoroscope, a doctor can look directly at the heart shadow. Another method of examining the heart, called cardiac catheterization, consists of inserting a catheter (long tube) into a vein or artery. This is used especially when heart surgery is being considered. At the start of an operation, the surgeon opens the patient's chest and exposes the heart. He then connects the heart-lung machine to the patients' circulatory system and switches on the pump. An oxygenator takes over the job of the lungs, removing carbon dioxide from the blood and replenishing it with oxygen. The surgeon can now stop the heart, open it, examine it for defects, and repair it. With new and sophisticated equipment. up-to-date knowledge and skilled surgical technique, and the cost only one tenth that in the United States or Japan, open-heart surgery represents a major step forward in the Republic of China's medical history. One of the major diseases affecting infants and children, congenital heart disease, is believed to involve 8.14 of each 1,000 births. The pathophysiological consequences developing in these infants and children are of a severe nature, including weakness, hypoxia, breathlessness, congestive heart failure and even death. Although treatment of this type of heart disease has shown good results, it has been a matter of regret in the past that several cases were left untreated for financial reasons. The National Taiwan University Hospital, therefore, decided to establish the Cardiac Children's Foundation of the Republic of China in October 1971 to achieve the goal of "saving one cardiac child patient a month." Since the establishment of the foundation, a total of NT$10 million (US$280,000) has been raised and more than NT$7 million has been used to conduct open-heart surgery on 300 children. Another group of physicians and humanitarians set up a second heartfund at the Chang Gung Memorial Hospital, which was started with NT$76,000 donated by Schafer in an expression of gratitude. One of the first patients to benefit was Shih Mi-wei, a young girl who had suffered from severe congenital heart disease from the age of one month. Because Shih weighed only six kilograms, while the standard weight for patients needing such surgery is 12 kilograms, the doctors decided to use ice to lower the body temperature and slow circulation so the heart would remain dry during surgery. The patient survived, and her innocent laughter, healthy complexion and agile movements have brought joy to her family again.
[Picture Caption]
The heart-lung machine (above) and pig's heart valve (right) together with other sophisticated equipment (top), in the hands of skilled surgeons, have made successful open heart surgery possible.
Lin Yu-chun (left) and Shih Mi-wei (right) have brought joy back to their families again after undergoing successful heart surgery.
