Cardiac surgery: Patients in the west of Ireland, who have a higher incidence of heart disease than people in Dublin, are less likely to be offered bypass surgery or angioplasty (the use of a balloon to clear a blockage), doctors have been told.
Speaking at the second annual West of Ireland Cardiology Update, Sue Hennessy, project manager of cardiovascular services with the Health Service Executive (HSE) West, said that despite a recent increase in the number of angioplasties performed at University College Hospital Galway (UCHG), there was still evidence of a geographic inequity for patients with heart disease living in western counties.
Using figures comparing standardised death rates with discharge rates for coronary artery bypass grafts, Ms Hennessy illustrated how people in Galway, Mayo and Roscommon had higher death rates from heart disease than the national average. At the same time, however, they received a lower number of cardiac procedures than people from other parts of the State.
Plans to make cardiac surgery available at UCHG have been in place since 2003, when the capital development for the programme was completed. Dr Kieran Daly, consultant cardiologist at the hospital and medical and research director of Croí, the West of Ireland cardiology foundation, confirmed that the unit's first cardiac surgeon had been appointed and was expected to take up his post soon.
"The open expectation is that cardiac surgery will begin in UCHG in 2006," Dr Daly said. "We also expect to be carrying out thoracic surgery [ for the treatment of lung cancer] as part of our remit as a supraregional cancer centre."
However, it is understood there is concern that the public service recruitment embargo will delay the start of cardiothoracic surgery in the region. Between 40 and 50 key operating theatre personnel are needed before coronary bypass and other thoracic surgery can begin in Galway.
But a spokeswoman for HSE West said yesterday: "We have approval for the appointment of a consultant cardiothoracic surgeon and key posts to plan for the commissioning of cardiac surgery."
In a significant development, the number of angioplasties performed at UCHG has more than doubled in the past three years, to more than 600 procedures a year, following the appointment of two additional consultant cardiologists and the opening of a second angiography laboratory.
Since 1997 the number of angioplasties carried out in UCHG has increased by 900 per cent, compared with a 200 per cent increase in the number of procedures nationally, reflecting the long-standing geographic inequity, the Croí meeting was told.
Meanwhile, research published yesterday in the Journal of Advanced Nursing suggests that men and women having heart attacks are treated differently by the hospital system.
Dr Sharon O'Donnell and a team of researchers from the School of Nursing and Midwifery at Trinity College Dublin followed up 890 patients admitted to coronary care units in Dublin's six major teaching hospitals to see how long they waited for both admission and treatment.
They found that, on average, women were medically assessed 30 minutes after arriving in the accident and emergency department compared with 20 minutes for men. Just 35 per cent of women with heart attacks received clot-busting drugs compared with 43 per cent of men.
"Treatment delays experienced by women may limit their potential to achieve maximum benefit from perfusion [ clot-busting] therapies," Dr O' Donnell said. "This study raises important concerns about equitable healthcare practice."