Coronary Angiogram, Angioplasty & Stenting

About one month ago my uncle (father’s younger brother) had a sudden pain in his heart and got admitted to the hospital. According to doctors’ diagnosis, he has got the heart disease which is called Unstable Angina. This is caused by a block in blood vessels which supply blood into our heart muscles. After one week, my uncle was discharged and back home. But after few days, he was suffering from a breathing difficulty which comes on and off time to time. As this breathing difficulty was increasing, we decided to meet cardiologist, Dr. Vajira Senarathne. His recommendation was to do a Coronary Angiogram which is also known as Coronary Catheterization.

The angiogram was done last monday and I was there. I was amazed by the simplicity and outcome of this technique. An extremely thin catheter is inserted into a blood vessel which goes into the heart. It was inserted from a place near wrist in my uncles case. But sometimes it is done from the upper area of leg as well. This catheter injects a dye into coronary arteries which are the three main vessels that supply oxygen rich blood into our hear muscles. After that, the flow of blood is recorded through a special x-ray technique. The final outcome is a video which shows the flow of blood in coronary arteries. It clearly shows the thickness of flow and it gives a clear idea of which blood vessels got narrowed thickness. Those areas should be treated immediately. Interesting thing is that my uncle even doesn’t know that a catheter was inserted into his body. It is 100% pain less and takes a very short time. He says it was like a simple injection.

Following video shows an example of the output an angiogram.


According to my uncle’s angiogram, he has got a bit long narrowing in one of his three coronary arteries. Doctor’s recommendation is to do a stent treatment. In that also, a catheter is inserted in the same way and the blocked area is cleared using a technique called angioplasty and a metal mesh is kept there to save the artery from blocking again. It gives almost the same result as an open heart bypass surgery with minimum pain and effort. That’s why I was amazed with these new technologies. So we are going to do this treatment for my uncle next week.

The videos given at http://yourtotalhealth.ivillage.com/coronary-angiogram.html provides a perfect idea of angiograms and stenting. You will find it extremely interesting.

Advertisements

About isurues
Age : 24 Date of Birth : 05.11.1984 Country : Sri Lanka

35 Responses to Coronary Angiogram, Angioplasty & Stenting

  1. indraka says:

    hi isuru,

    im 34 yrs old IT lecturer @SLIIT. I got a MI on march 8th sunday.
    and have been treated in cardiac unit in National hospital colombo. there after angiogram, they found two clots, one of which is bit serious (90% block).

    There i consulted dr.vajira senarathne. he said that as the serious clot is still fragile, I have to rest for 3 weeks.

    He is gonna examine me on 8th April (after that 3 weeks time) to decided a date for the stenting.

    he said that I need two stents for the two blocks. Now im geting ready for that stenting surgery which is gonna take place in Durdens hospital.

    Pls update me with the experience u r having abt ur uncle.

    Thanks in advance
    Indraka

  2. isurues says:

    Hi Indraka,

    My uncle went through the stenting surgery on 19th January at Durdens. Now he is 98% normal and back to work.
    Actually you have nothing to worry about. Because Dr. Vajira Senarathne is the best doctor in SL for this. And also this surgery is a simple one. In my uncle’s case it took about 1 hour. He said that the feeling is not much different to the Angiogram and there were hardly any pains.
    After the stent you’ll have to take about 8-10 drugs for about 1 month. After that it’ll be less.
    If you want to have any more details, please feel free to ask me. Wishing you good health very shortly..

    Thanks,
    Isuru

  3. indraka says:

    Dear Isuru,
    Thanks a lot for ur quick reply. If im not bothering u, wanna know few more things.
    How long he was there in hospital for the stenting procedure? I heard like its only three days (one day b4 stenting,stenting day and following day). is it true that the patient will be discharged on following day?

    And how long was he on rest (on official leave) after the stenting. Heard like its only three weeks and might depend on the case. In ur uncles case, how long he was on leave?

    thanks again, dear friend.

    Indraka

  4. isurues says:

    Hi Indraka,

    Yes it’s true that you have to be in the hospital only for 3 days. But the stent is done on the first day. My uncle went through it at about 10PM on the first day. He was discharged at about 1PM on the third day.

    My uncle was on leave for about 1 month after the stent. But that is because he had a breathing difficulty which was there from the beginning of his heart pain. It took a while for him to recover from that breathing difficulty. But most patients don’t get such issues.

    Do you have a breathing difficulty now? I don’t think so. If no such issues, you’ll be fine within one or two weeks after the stent. I’ve heard of some people who have returned to work just in 2,3 days after the stent. That’s because it doesn’t cause any pains or cuts like by-pass surgeries.

    Isuru

  5. indraka says:

    Dear Malli,
    I promise that this is the last time im bothering u on this regards. I think now we 2 are close enough to ask some sort of personal question. If u dont mind to tell me, what was the amount of hospital bill? If u dont mind, pls details it out.(dr charge, stent price, hospital charge etc.)

    there i can get a rough idea of my bill also as the only difference is in my case, 2 stents. All other factors like dr and hospital are same.

    Did dr do the purchase of stent for ur uncle or have u contacted refs personally?

    Last thing to ask, has it been done thro wrist (hand) or leg?

    Pls apologize me if im bothering u. Hope that u can understand my curiosity as i never expected to have heart trouble at this early age, 34.

    Thanks dear
    Indraka

  6. isurues says:

    Hi Ayya,

    Actually it’s a pleasure to share these with you. Don’t think you r bothering me. This is nothing.. Feel free to ask any thing even after this :-).

    In our case, bill was 505,000 rupees. That includes everything, stent, hospital charges, doctors’ charges etc. As I can remember, the rough breakdown is as follows.

    Stent : 300,000
    Hospital : 140,000
    Doctors’ : 65,000

    If doctor recommended 2 stents for you, in my understanding, the total cost for you will be around 700,000.

    Stent was prepared by the hospital and we didn’t have to do anything regarding those.

    It was done through the wrist in my uncles case. It will be the same as your Angiogram. They will use the same place. I think they first try the wrist. For some patients, it’s hard to do it through the wrist. In such cases, they move to leg.

    Yes ofcourse, I understand your situation. Nobody expects these things in ur age. But don’t worry.. Technology is there for you. This is a simple surgery through which u can recover 100%.

    If u have anything more to know, feel free to ping me.. 🙂

    Isuru

  7. isurues says:

    Hi Ayya,

    I forgot one more thing. You can apply for presidents fund and ETF for funds. I think you’ll be able to have about 300,000 from those two funds (~150,000 each).

    If you are hoping to apply for those funds, please make sure you get separate letters for those 2 places from the Durdens hospital and from the doctor. They normally issue letters for most of the patients are they know the formats and addresses of those places.

    Isuru

  8. indraka says:

    Dear Malli,

    Thanks a lot for the info. Yah…my wife is already engaged in the process of geting funds from both u mentioned.

    After conversation with u,,,im pretty ready for the surgery. And u r such a great person with warm heart.

    I’ll keep in touch with u even after the surgery. I’ll update u after the procedure.

    Thanks again dear bro,,,

    Indraka

  9. isurues says:

    Hi Ayya,

    It’s a great pleasure for me also to help someone like you with what I know about these things.

    Wish you good health very shortly :-)…

    Isuru

  10. mark says:

    Rampart2 source code available yet?

  11. nihal jayathilake says:

    All this is targeted information. There are so many cases proof can be given that he has messed up patients lives. Even the stents of lower quality supplied by this money monger. Do not let a blog posting ruin your life. Please Please take second opinions from some genuine doctors

  12. isurues says:

    Dear Mr. Nihal Jayathilake,

    Thank you very much for sharing your experience with this particular doctor. It will be helpful for the other patients who are going to consult him.

    Actually in my original post, I never wanted to market the doctor and I just wanted to explain about the technology behind this. And also I’ve shared my experience with the intention to make it useful for others. I’ve got no relationship to the doctor other than my uncle being a patient of him.

    So if you have any specific details about the doctor or anything, please share. That will be definitely help the others.

    Isuru

  13. nihal jayathilake says:

    Dear isuru,
    Thank you for being open about your posting. Already some web posting are done about his mal practices. The most recent victims was Mrs. Nayana Rupasinghe – CEO of the Finance company. Some more affected patients are now raising their voices. I now know that you are genuine – since you did not delete my posting.

  14. John Paul says:

    Here is My Experience with Dr. Vajira Senaratne

    Please Circulate – Keep Away from Gold Diggers in Sri Lanka

    Nayana Rupasinghe – Willful Medical Negligence

    Mrs. Nayana Rupasinghe (Former Executive director of ‘The Finance Company limited’) was admitted to the Durdans hospital Ltd. for a chest pain under the care of Cardiologist Dr. Mithrakumar on 29th March 2012 around 10.00 am. Dr. Mithrakumar – The consultant cardiologist advised that there is no immediate danger to her life and that she should be prepared to undergo an Angiogram, by reducing sugar levels, as she was acutely diabetic.

    Thereafter a second opinion was sought from another well-known Cardiologist Dr. Stanley Amarasekara and he too confirmed that there was no immediate need to take her through further procedures on an urgent basis and advised to stabilize her blood sugar levels over a two-week period and thereon to perform an Angiogram.

    However “Maraya’s” search for her precious life never ended there. She was advised by some of her friends that it may be better to obtain a further opinion from another cardiologist “Dr.” Vajira Senarathne – who has created a hype for himself through unscrupulous means. He has just returned to the country on 29th morning itself after along overseas visit. The said doctor, having returned to Sri Lanka the same day and having worked without any rest at the hospital, saw Nayana after seeing around 50 patients at Asiri Surgical Hospital.

    At the medical consultation he convinced Nayana that there is a risk to her life and she should be taken through an Angiogram despite that she was not ready for any medical procedure due to high sugar level of 344 and was not fasting (had her lunch around 5 pm ). After carrying out the Angiogram – he convinced her that she must undergo an immediate angioplasty procedure vis-à-vis open heart surgery, since he was aware that she was covered under medical insurance. He reassured the patient that he has done over 5,000 procedures and so far only one patient died. Further he himself being the supplier of “Stents” at an exorbitant price he had vested interest in taking her through an angioplasty procedure and the quality of stents used are also questionable. To make her ready for the procedure – she was given a high dose of insulin to reduce the sugar level and he just treated the patient as a piece of mechanical equipment. Soon after the said Angioplasty procedure, Nayana succumbed to death and the said doctor fail to give any explanation to date.

    Opinions sought from several medical experts in the field confirmed that the procedure adopted by Vajira Senarathne in handling the case was a clear and willful deviation from the required procedures. He had omitted several mandatory prerequisites before performing such a risky and serious operation and thereby the patient had been very gravely mishandled, causing her death. Later on it was revealed that several patients treated by him had to face the same ordeal or post procedure complications. In some situations he has used unsuitable stents for the purpose leading to internal hemorrhage as well. To recover some patients had to undergo a bypass surgery despite paying good money this money monger for his stents. That factual information will be shared in future.

    If you do care about your loved ones’ lives – please keep away from this money hungry “Doctor” (Ashamed to call him a doctor – It is a disgrace to genuine doctors). Please circulate as much as possible.

  15. read this blog : http://healthwatchsl.blogspot.com/ more on Dr.Vajira Senaratne,…

  16. Nalini Desilva says:

    Following were some of the responses by different bloggers with regard to the article on Mrs. Nayana Rupasinghe uploaded by Mr. John Paul.

    AnonymousApr 27, 2012 09:02 AM

    what a nasty way to drum on controversy. This doctor is indeed an honest and capable surgeon and shouldn’t have to read such articles. Surgery isn’t a surefire way of getting better so inevitably things may not work out the way one would hope. To slander a doctor for professional misconduct using only options and here-say is just lazy and contemptuous. Maybe your time would be better spent revising your own professionalism.

    AnonymousApr 27, 2012 10:48 PM

    I wouldn’t suggest disproportionate attacks of this caliber on professionals. I too am a person engaging in a profession we take decisions professionally after giving due consideration the material facts. These half heartened attacks on doctors or any other professionals in an unprecedented manner would not only cause grave prejudice to the very doctor but the whole of medical fraternity who put their life in to the profession. Please be aware of such subjective opinionated remarks by bloggers of this nature in the sake of Dr. Senarathna and many other professionals who we lean on at the hour of need.

    AnonymousApr 27, 2012 01:26 PM

    I agree with the above comments. The blogger must have ulterior motives as highlighted by the very biased language used.

    In quotations are some of the facts which I found in a Pubmed article regarding this matter: http://www.ncbi.nlm.nih.gov/pubmed/15784875.
    Diabetic patients are considered to be a “high risk group” and “Patients with diabetes mellitus account for approximately 25% of the nearly 1.5 million coronary revascularization procedures performed each year in the United States and experience worse outcomes compared with non diabetic patients”
    “Coronary artery disease (CAD) is virtually ubiquitous in adults with diabetes mellitus compared with nondiabetic patients and portends a worse prognosis.”
    Moreover, “Coronary heart disease (CAD) is the most common cause of death in diabetic patients, at least half of whom die from cardiovascular causes.2 Diabetic patients are 2 to 4 times more likely to develop CAD than nondiabetic patients and to manifest this disease earlier in life.5-7”

    “Although patients with diabetes frequently have concurrent risk factors, diabetes itself is a powerful independent risk factor for cardiovascular events.1 There are several pathophysiologic features of atherosclerosis in diabetic patients that contribute to their worse prognosis and unique response to coronary revascularization. Metabolic and hematologic abnormalities associated with type 2 diabetes include hyperglycemia, insulin resistance, dyslipidemia, inflammation, and thrombophilia.14 Platelets express more Gp IIb/IIIa receptors and are more prone to aggregation, particularly in the presence of hyperglycemia.3 Together these abnormalities contribute to development of hypertension, endothelial cell dysfunction, accelerated atherogenesis and, eventually, coronary thrombosis.”
    “In addition to a greater atherosclerotic burden, diabetic patients have a larger amount of lipid-rich plaques, which may be more prone to rupture.23 In an angioscopic study evaluating patients with unstable angina, those with diabetes had more fissured plaques and intracoronary thrombi.24”

    The enlightened reader will now see that Ms. Nayana, who was a diabetic patient, did have to undergo revascularization due to a severely blocked coronary artery and due to the risk of dying from CAD due to the very high risk of forming “intracoranry thrombi”. It is common knowledge that a diabetic patient that has a high sugar level , cannot bring down the sugar level naturally and that insulin administration in the form of a shot or a capsule is required. And irrespective of the sugar level, after reading the above facts it is understood that the patient was no way healthy. She was then in fact fighting for her life in a life or death situation.

    Also I would like to know the medical knowledge this blogger has had before commenting on such a medical matter. One has to consider the vast number of lives this physician has saved before writing such articles with great emotion. We must hope that the physician will come to know about this blog and will present the events that led up to the death of the patient. 2/5000 deaths, from a surgeon’s point of view, are considered quite rare. Even common sense would tell you that the probability of dying under the supervision of this physician is rare. A physician who has dedicated his life for over 30 years into cardiology, from my perspective would know the accurate course of action.

    AnonymousApr 27, 2012 01:27 PM

    Cont…..
    Furthermore, I would like to enlighten the blogger about PATIENT AUTONOMY here. The patient received 3 medical opinions, and she chose to undergo the treatment. The physicians always ensure that the patients know about the risks and outcomes prior to surgery. Without the consent of the patient, no physician would proceed due to very obvious liability. To assume that the patient was almost forced into the procedure seems very illogical. If the patient did agree to undergo coronary catheterization to re-vascularize her severely blocked coronary artery (as she would have otherwise died due to myocardial infarction), we should let the patient die in peace and respect her choice to undergo treatment to save her life. After all, although we love our relatives we must make sure that we respect their choice to live longer by undergoing medical treatment. Put yourself in the patient’s shoes and see how you would have reacted if you knew that you had a severely blocked coronary artery? Think of cancer patients that undergo chemotherapy. While very well knowing about the side effects and later experiencing excruciating pain from all the side effects, they still never give up hope and continue to fight for their lives. Therefore in my opinion, we must all respect the Ms. Nayana’s decision to undergo treatment under the skilled and experienced Dr. V. Senaratne. One must take all obvious facts into account before publicly humiliating a physician that had dedicated his life to help patients extend their lives. It is unfortunate that people think that physicians are gold diggers and murderers. How ignorant people are about the hard lives physicians lead on a day to day basis, the stress and physical hardships one faces is no walk in the park my friend.

    AnonymousApr 27, 2012 11:23 AM

    What ever the cause is, the death of the patient is very sad. However, the article is a cynical attack to Dr. Denarahne, beyond proportion. The language of this demonstrates there is an ulterior motive to undermine Dr Senarathne, out of malice and jealousy. It is immoral and illegal to publish such a un-scrutinised statement in a public forum.

    AnonymousApr 27, 2012 08:16 AM

    This article seems very biased and factually inaccurate, because from what I have heard Dr Vajira Senaratne is a very reputed compassionate doctor who has saved thousands of lives. It’s absolutely disappointing to see such a dedicated doctors name being associated with the word ‘murderer’. It is also clear that this article has been written in such a third class style.

    AaliyaApr 27, 2012 08:32 AM

    I completely agree with the above cmment. What bullshit is this article. Such articles should not be even allowed to be published. It is shameful and ridiculous of whoever has published this article , as it is inappropriate to call someone ‘murderer’ especially such a sincere dr without any proof. My friends relatives have been treated by this doctor, and thy ve said nothing but good about him. The moment I saw the forward of this cheap article, I rly got upset as I knw what I kind of doctor he is. I really hope other patients of his will come forward n talk about his sincerity. Shame on everyone who calls my doctor a murderer.. shame on you all.

    AnonymousApr 27, 2012 11:23 AM

    This article is baseless. I have had first hand experience with this doctor, and I have no link to him what so ever. He treated me with great care. I saw the amount of dedication that he has for his profession. I don’t understand why anyone would call him a murder, as I am quite convinced that he has given a second chance to live for a majority of his patients, including myself. I am deeply sorry for your loss, but it is too cheap to call such a genuine doctor a ‘murderer’. It is nice to see that everyone who has commented sees beyond this article.

    AnonymousApr 28, 2012 12:37 AM

    My deepest sympathies goes out to Mrs Nayana’s family. However, reading this article was an absolute waste of time.
    It is unclear how he supposedly ‘forced’ the patient into the surgery. This sounds quite unreasonable. Also from the experiences of my friends, relatives etc, he is opposite to a ‘gold digger’,’murderer’. These accusations seem quite blown out of proportion. It is understood that when a close loved one of a person expires, people in grief may try to blame the death on someone, but the manner these individuals have adopted to degrade this doctor, is sinful and malicious. To be very precise, vile.

  17. Gunawardena Dissanayake says:

    I visited this particular doctor few year ago at Nawaloka hospital. My appointment was at 6:45 pm and number was 9. I found nearly 60 patients are waiting for him and realized he is going aboard next day and combined patients for two days. While waiting for him around 8:30 pm one patient collapsed and sent for emergency room. Finally he came about 9:30pm after visiting other private hospitals. Around 10: 00pm as the 18th patient I was able to enter into his room and found two interns doctors helping him, an attendant and 6 patients ( two patients with intern doctors, one on the examination bed, one with Dr Senarathne and two others are standing to see him) in a tiny room. This was a very small room with 10 people, totally congested ( Honestly I felt suffocation) and no space even to move and of course no privacy at all. When my turn came he took less than one minute to listen to my history and order several tests.

    After completing the tests, I visited him again after two weeks when he back to the country. I had the privilege to get the same experience, very late arrival, congested room and several patients. He glanced my reports with one second and sent me for the patient bed. I was there nearly 15 minutes for him to come and check. Even when he is examining me, he talked to his intern doctors and gave instructions for treatment to other patients. In my reports I found I had elevated cholesterol level. However after examining he asked why I came to see him. I was amazed from this question. Then I told him my initial sign & symptoms of chest pains and history of high cholesterol level. Then he said, Yes, you have high cholesterol level, get these tabs and come back again in three month. Is this the service do we expect from a consultant after paying? Where is the quality of service? medical ethics?

  18. Tania says:

    I think one needs to look at both sides of the story. Definitely this doc seem to be one of those who believe his time is more important than anyone else’s. I changed 3 doctors in the past who I felt had same ethics. I think it is upto the patient to choose the “right” doctor – the good thing is that in SL we have quite a choice.

    As for quality of his treatment, from what I have read people seem to be divided on that (some very happy while other’s have suffered). I think as general public, we must highlight the issues but leave but perhaps not go that extra mile of advicing others against him or even slandering him. Let the other’s make up their own minds.

  19. dayani says:

    Dayani De Silva
    Dr. Vajira Senaratne presently in circulation. The attempted vilification of this eminent cardiologist thereby is regrettable, unfair and unreasonable.
    We have known and have had the benefit of his dedicated professional service over a long period. My husband has been under his care for nearly fifteen years and our experience has been most re-assuring. Despite many complications due to chronic diabetes, Dr. Vajira Senaratne has very skillfully and with outstanding commitment and dedication attended on my husband at all times of need.
    It was due to Dr. Senaratne’s sound judgment and prompt dedicated attention that my husband recovered from a very critical condition of a severe heart attack together with a virulent viral fever, uncontrollable blood sugar levels and resultant complications, a few years ago. Even calling in relevant specialists and coordinating with them was handled completely by him.
    We are most grateful to Dr. Vajira Senaratne and have always had and will continue to have the utmost confidence in him.

    Dayani de Silva

  20. preena says:

    Shanaaz Preena
    This is not fair. In fact very vindictive. What about all the lives Dr vajira has saved??? You know I am ever so grateful to vajira, mithrakumar and Naren. I have Mervin with me today. Yes it is very upsetting when you lose a loved one, however, that seems to be her fate. She has gone after several opinions, somehow wanting something done. And further, do we know the actual conversation that transpired between the patient and doctor. We ourselves, like several other patients, have somehow forced and pleaded to get an appointment over and above the number he limits ..now no one appreciates that. If vajira refused to see her and something did happen, they would have pounced on Dr. Mithrakumar for not doing anything about it…fate has it that she was meant to go. To the loved ones it is difficult. They want to squeeze some ones neck… but saying all these things about stents, etc, I do not know what the intention is ..it is indeed a smear campaign.
    I for one would vouch for his professionalism and would get my angio done by him.
    Indeed it is sad that nayana lost her life after this procedure. Very unfortunate. Peace be upon her … However this article seems to have a much deeper intention.

    Would appreciate very much if you would forward my response to the person who sent you the mail. Pls delete address details

  21. shaanaz says:

    Shanaaz Preena
    This is not fair. In fact very vindictive. What about all the lives Dr vajira has saved??? You know I am ever so grateful to vajira, mithrakumar and Naren. I have Mervin with me today. Yes it is very upsetting when you lose a loved one, however, that seems to be her fate. She has gone after several opinions, somehow wanting something done. And further, do we know the actual conversation that transpired between the patient and doctor. We ourselves, like several other patients, have somehow forced and pleaded to get an appointment over and above the number he limits ..now no one appreciates that. If vajira refused to see her and something did happen, they would have pounced on Dr. Mithrakumar for not doing anything about it…fate has it that she was meant to go. To the loved ones it is difficult. They want to squeeze some ones neck… but saying all these things about stents, etc, I do not know what the intention is ..it is indeed a smear campaign.
    I for one would vouch for his professionalism and would get my angio done by him.
    Indeed it is sad that nayana lost her life after this procedure. Very unfortunate. Peace be upon her … However this article seems to have a much deeper intention.

  22. Chamila De Silva says:

    I am an English teacher attached to a state school in the suburbs of Colombo. I could never forget how Dr Vajira Senarathne Consultant Cardiologost came to our help when my mother was almost at deaths door 3 years ago.

    My mother who was 73 years old at that time who was also a bad diabetic was collapsed and in a state of shock after complaining of a chest discomfort in November 2009, at her home in Moratuwa. We rushed her to the Durdans Hospital where she was diagnosed to have a heart attack and Dr Vajira Senarathne was called in. It was at 2 am in the morning and he looked very tired yet he took time to explain my mothers situation to my husband and me.
    As a young family with many demands we had limited financial resources available.
    Dr Senarathne DID NOT CHARGE A CENT from us as Doctors fees and we had to only pay for the stents and the hospital charges.
    For us, this Doctor has been an angel in disguise. I have visited the Cardiology Unit clinics of Dr Senarathne, who has always been very kind and helpful attending to my mother free of charge. It was here that I learnt that he is a doctor who has contributed immensely to develop the facilities and improve the care provided at the Cardiology unit. I have met atleast 6 patients like my mother whom he had treated in the private hospital free of charge.

    It must be hard on the family of the patient who died to accept the loss of a dear one. We were lucky that my mother survived but I vividly remember the words of the doctor prior to the procedure discussing the dangers of the cardiac catheterization and the risk of death from the disease.

    I write this email along with my husband Charith as I felt it is my duty by society to highlight the contrasting different aspect of this wonderful and compassionate doctor with whom I have associated over the past 3 years.
    I am not a medical expert to comment on the technicalities of a medical procedure, however as family of a grateful patient I must say that I have yet to meet a doctor of high caliber as Dr Vajira Senaratne whose kindness and dedication to his patients is highly commendable and his healing hands have relieved the suffering of hundreds of patients like my mother and no one could deny this fact.

    In our opinion, he is indeed a Gold Mine and far from being a Gold Digger.

    Chamila and Charith de Silva
    Moratuwa

  23. Nalini Desilva says:

    This is a reply to Gunawardana Dissaanayake’s and tania’s comments. I do not know how far the information you have shared, is true. However, from what I hear and from my understanding, he is a professional who has devoted his life to medicine and treating patients.That is probably the reason why a majority of people somehow try to fix an appointment with him and why he is so busy.I have heard that the waiting list to see doctor Vajira is about 2 weeks, as he sees a restricted number of patients.
    It is natural that when speaking about any professional, people may have thier own opinion,as it is subjective.
    However,one must also take into account the personal life of a doctor. Do you know exactly why he had to go abroad? he might have had an emergency as well? Do you expect doctors to be indivduals who do not have sudden urgent matters to deal with, concerning their own families and urgent cases involving other acute patients.One should not take into account rare incidents to judge an individual’s character and personality.

    I am sorry about the family members, who lost Mrs Nayana, we all understand how it feels as a death of a loved one is inevitable and therefore is experienced by almost all of us. However, this sort of writing just makes it look bad on the individual who has passed away, as I am certain that Dr Vajira tried his best to save her life.This article on Mrs Nayana Rupasinghe just demostrates the writing style of a completely different class of people. It is hard to read such a vile piece of writing to be very honest.

    Please think twice before you publish an article of this nature, as this is a clear character assasination and legal action against the editor and everyone involved, could be taken.This just brings about anxiety and false opinions about well known professionals and treatment options available. In fact if the relatives felt that the death was caused by the doctor, they should report this case to the SLMC and seek legal action, which is the proper way of getting about things,without having internet blogs and circulation emails.
    What they have done to degrade this doctor indirectly reflects thier own immoral nature.

  24. John Paul says:

    More about Vijira Senaratne

    I have been reading the e mail in circulation regarding the willful medical negligence case lead to the death of Mrs. Nayana Rupasinghe and was debating whether to respond to the same or not since I myself has been victimized by a similar situation.
    My brother Sumith Wijerathne worked as a cashier attached to the State Pharmaceutical Corporation married to Savithri who works at Bank of Ceylon Corporate office. They were blessed with three young promising sons and both of them had high hopes to educate their sons in the best possible manner they could afford but there source of income was solely dependent on the salaries they both drew.
    At his prime age of 51 my brother developed a mild chest pain and consulted Dr. Gotabaya Ranasinghe. He has been regularly treated by Dr. Ranasinghe and the doctor’s recommendation was to initially treat him with medicine and subsequently to take him through an open heart surgery procedure as a long term solution.
    However, similar to previous e mail in circulation again for my brother also, some of his friends recommended Dr. Vajira Senarathne’s name and consulted him for a second opinion. At the consultation they had with Vajira Senarathne he requested to them that he should go through an angiogram and after verifying they had a medical insurance cover through my sister in law he convinced them to go through Angioplasty process and inserted three stents. After the procedure for about 4 months he was normal and again he felt something wrong with heavy chest and breathing difficulty.
    On consulting Vajira again he gave some medicine and said “Ganan ganna epa” (meaning just ignore). However his situation became worse and was admitted to Nawaloka hospital and realizing that Vajira was taking it very lightly again Doctor Gotabaya Ranasinghe was consulted. After carrying out some investigations it was revealed that some inserted stents were clogged and my brother had to be taken for an open heart surgery on emergency basis to overcome his deteriorating health. Thanks to timely intervention of Doctor Ranasinghe my brother still lives – although he is not the same active person he used to be and at the expense of spending three times the cost of an open heart surgery for angioplasty and hospital expenses. In addition he had to request for early retirement due to his poor health condition exposing the family to great financial difficulties.

    Although I was very keen to go through a litigation process – after going through the above ordeal my brother did not want to proceed any further simply because I am living outside the country and further more you need adequate financial resources to pursue a litigation case.
    However with this time and day – Internet has become a great leveler to expose this type of professional malpractices so that the clients can avoid using the services of so called “doctors” who does not care about the patient welfare. I urge each one of you if you have faced a similar situation please let others know so that we do not become innocent and ignorant victims of those gullible personnel.

  25. Ranjith Bamunukulaarahchi says:

    I have been reading the e mail in circulation regarding the willful medical negligence case lead to the death of Mrs. Nayana Rupasinghe and was debating whether to respond to the same or not since I myself has been victimized by a similar situation.
    My brother Sumith Wijerathne worked as a cashier attached to the State Pharmaceutical Corporation married to Savithri who works at Bank of Ceylon Corporate office. They were blessed with three young promising sons and both of them had high hopes to educate their sons in the best possible manner they could afford but there source of income was solely dependent on the salaries they both drew.
    At his prime age of 51 my brother developed a mild chest pain and consulted Dr. Gotabaya Ranasinghe. He has been regularly treated by Dr. Ranasinghe and the doctor’s recommendation was to initially treat him with medicine and subsequently to take him through an open heart surgery procedure as a long term solution.
    However, similar to previous e mail in circulation again for my brother also, some of his friends recommended Dr. Vajira Senarathne’s name and consulted him for a second opinion. At the consultation they had with Vajira Senarathne he requested to them that he should go through an angiogram and after verifying they had a medical insurance cover through my sister in law he convinced them to go through Angioplasty process and inserted three stents. After the procedure for about 4 months he was normal and again he felt something wrong with heavy chest and breathing difficulty.
    On consulting Vajira again he gave some medicine and said “Ganan ganna epa” (meaning just ignore). However his situation became worse and was admitted to Nawaloka hospital and realizing that Vajira was taking it very lightly again Doctor Gotabaya Ranasinghe was consulted. After carrying out some investigations it was revealed that some inserted stents were clogged and my brother had to be taken for an open heart surgery on emergency basis to overcome his deteriorating health. Thanks to timely intervention of Doctor Ranasinghe my brother still lives – although he is not the same active person he used to be and at the expense of spending three times the cost of an open heart surgery for angioplasty and hospital expenses. In addition he had to request for early retirement due to his poor health condition exposing the family to great financial difficulties.

    Although I was very keen to go through a litigation process – after going through the above ordeal my brother did not want to proceed any further simply because I am living outside the country and further more you need adequate financial resources to pursue a litigation case.
    However with this time and day – Internet has become a great leveler to expose this type of professional malpractices so that the clients can avoid using the services of so called “doctors” who does not care about the patient welfare. I urge each one of you if you have faced a similar situation please let others know so that we do not become innocent and ignorant victims of those gullible personnel.

  26. Natalie Soyza says:

    The truth. The whole truth. And nothing but the truth.

    The chronological order of facts

    1.Mrs. Nayana Rupasinghe, accompanied by her husband consulted Dr.Vajira Senaratne as they wanted a third opinion for her prevailing medical condition of recurrent episodes of chest pain (unstable angina by definition, which is caused due to critical narrowing of one or more of coronary arteries supplying heart muscle). This appointment was obtained with the intervention of a friend, whose request Dr.Senaratne didn’t want to refuse despite his calendar being over booked.

    2.Since her history was clearly suggestive of unstable angina and the patient had been a poorly controlled Diabetic for more than 17 years, Dr.Senaratne advised them on an early angiogram and revascularization as also advised by the first cardiologist who had seen her in the morning. The Rupasinghes’ readily agreed for hospitalization.

    3.On admission, Mrs.Rupasinghe was prepared for a coronary angiogram and written consent was obtained after explaining the risks and benefits of the procedures. She was taken for the coronary angiogram after appropriate pre-op preparation including adequate period of fasting.

    4.The angiogram revealed severe blocks in all three coronary arteries (arteries supplying blood to heart muscle) with critical narrowing (more than 90% in two of them).

    5. Following the angiography findings, revascularization options of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (angioplasty) were discussed by Dr.Senaratne with Mr and Mrs Rupasinghe. In fact the husband was taken to the control room and shown the angiogram findings and further taken to the cath lab with scrubs to discuss the options with his wife which took over 30 minutes. The advantages and disadvantages of each procedure were explained in detail and the advantage of CABG over angioplasty was highlighted as she was a diabetic with triple vessel disease. However, THEY OPTED FOR ANGIOPLASTY as it was minimally invasive.
    (The American Heart Association guidelines clearly state that in high risk unstable angina patients, early angiogram and revascularization are recommended prior to diabetic control).

    6. The procedure was initiated with another cardiologist, cardiac anesthetist and routine cardiac cath lab staff. All lesions were successfully stented with Xience Prime Drug Eluting Stent (rated as the best stent currently available worldwide proved by multicenter studies – current authorised dealer in Sri Lanka is Lifeserve Ltd, a fully owned subsidiary of The Sumathi Group). Successful angioplasty and stenting results were obtained in all the vessels with normal flow and no complications.

    7. As per the normal angioplasty procedure, the patient was transferred to a trolley to be moved to the coronary care unit for further observation.

    8. While Dr.Senaratne was explaining the findings to Mr.Rupasinghe, it was noticed that the patient had gone into cardiac arrest and she was immediately rushed back onto the cath lab table and cardiopulmonary resuscitation was initiated with the arrest team being summoned. However, despite aggressive prolonged resuscitation and ventilation for 3.5 hours, the patient could not be resuscitated and death was confirmed 4 hours after the angioplasty.

    9. A detailed explanation which resulted in this eventuality was given by all the doctors involved in the procedure to the family.

    10. It was clearly explained that the patient was treated with the best of knowledge and expertise, in accordance with the current practice. Unfortunately the rarest complication of death occurred due to acute stent thrombosis (which is caused due to drug resistance which no cardiologist could predict in advance).

    11. Understanding the sensitivity of the situation and the grief of the family, all material relating to the patient’s medical treatment was released to the family with the approval of Dr.Senaratne.

    12. It is noteworthy that none of the cardiologist who treated the patient charged any fee.

  27. Natalie Soyza says:

    Ask yourself these questions ?
    *Was Mrs.Rupasinghe forced to consult Dr.Senaratne ?
    *Was Mrs.Rupasinghe forced to ignore the advice of 2 other *Cardiologists before consulting Dr.Senaratne ?
    *Was Mrs.Rupasinghe forced to undergo angioplasty treatment by Dr.Senaratne ?
    *Was Mrs.Rupasinghe ill informed of the possible risks of angioplasty in a Diabetic patient ?
    *Was Mrs.Rupasinghe pre-op prepared ?
    *What is the global norm followed, when a Diabetic patient is subjected to angioplasty ?
    *Did Dr.Senaratne use inferior stenting material ?
    *Did Dr.Senaratne shy away from sharing vital information and keeping both Mr and Mrs Rupasinghe in the dark with regards to the medical treatment ?
    *Could Dr.Senaratne, knowing Mrs.Rupasinghe’s unstable angina condition and the poorly controlled Diabetes for 17 years advice the patient to postpone the procedure ?
    *Had Dr.Senaratne learned certain vital facts from the angio but still not intervened and the patient died prior to the bypass, can he be blamed for negligence ?
    *What should be our attitude and stance? Is it to encourage doctors like Dr. Vajira Senaratne who had walked that extra mile and saved many lives evident by testimonials or falsely accuse them for their dedication?

    Who really is Dr.Vajira Senaratne ?

    *He is a Consultant Cardiologist attached to the National Hospital of Colombo having a track record of 15 years of experience as an interventionist cardiologist in public service.

    *He is the current President of the Sri Lanka Heart Association.
    He is one of the pioneers of angiography, angioplasty, stenting and percutaneous trans mitral commisurotomies (as a result many pregnant patients with tight mitral stenosis have had successful deliveries). He has performed majority of his procedures, which is a vast number, in public hospitals in Sri Lanka.

    *Most of the present generation of cardiologists are his trainees.
    He has a reputation for handling complicated cases with the patient’s best interest at heart and has therefore won the respect and admiration of the medical fraternity (a case in point is where a patient was brought to Durdans Hospital following a heart attack. The angiogram showed a left main critical lesion and the patient was immediately referred to for surgery. A leading surgeon who was consulted refused to take the case, saying there was a high risk of death. But Dr.Vajira Senaratne, opted to give the patient another chance at life. He inserted an intra-aortic balloon pump and successfully stented the left main and left anterior descending artery, saving the patient’s life).
    Both public and private sector hospitals in the country endorse the credibility, accountability and skill of Dr.Vajira Senaratne, whose professional contribution is greatly valued.

    *His humane characteristics and sensitivity are displayed in the cordial manner in which he treats patients of all walks of life.
    Dr. Senarathne is one of the most sought after guest speakers in many forums here in Sri Lanka and overseas in the field of interventional cardiology.

    Is it fair to twist the facts
    when the truth
    is staring at us in the face ?

  28. Natalie Soyza says:

    Mr ‘John Paul’ does not seem to have any other work to do apart from fishing for bad comments from people involved in the ‘same smear campaign’. This is quite pathetic to watch. This disgusting attempt to tarnish a well known cardiologist’s reputation, with FACTUALLY INACCURATE articles will be sorted out by god/karma soon.

    What good are you doing to the late Mrs Nayana Rupasinghe by this low class campaign? Insulting the doctor who made an attempt to save her life?

    I honestly do not feel that this article has anything to do with Mrs Nayana Rupasinghe, it is nothing but a well organized smear campaign.

    This reminds of a sinhala saying ‘pala athi gasata thamai gal mul wadenne’

  29. Natalie Soyza says:

    I am extremely sorry if Mr ‘John Paul’ did not understand that sinhala saying.

  30. I think the real reason, picking up individual mishaps and blaming personalities does not solve the problem, in fact we are evading the problem or problems.
    The solution is people education on health, “doing the right things” as the Australians would say, is the solution. There are people in this country having diabetes, among other chronic life threatening diseases, not knowing that they do suffer from such diseases. For them they prefer to continue their normal lifestyles, like Eddie Jayamanne’s song,”Kapalla beepalla jolly karapalla………”

    Sri Lanka may be having the best doctors, best health systems, but people are not getting the benefits prophylactically. The country is too poor to handle the problem. A donation or a gift given by one of the big nations like China, not for massive projects but just to give a better deal for our aging and sick
    population would be more beneficial to mankind, rather than seeing concrete jungles built all over the cities

    Just a suggestion!h

  31. gamini says:

    Why did these well educated people ignore advice of first two qualified cardiologists and seek advice from a third cardiologist?This is a very common scenario where patients seek advice from more than one specialists and get in to trouble. There is a Sinhalese saying that Aththen aththata panina kurulla themi nasie.

  32. Jaliya says:

    Foreign doctors practicing in Sri Lanka without registering with the Sri Lanka Medical Council have become the cause of many complaints with very little recourse to a satisfactory appeal process or accountability. The full extent of the lackadaisical registration process and enforcement is fully experienced unfortunately after an event – leaving the patient with little recourse – apart from turning to the local private hospital and local medical staff. That in itself presents a conundrum to those patients who have paid heavily for the services of a foreign doctor as opposed to a local doctor.
    A retired consultant paediatrician, Dr Asoka Thenabadu (68) told The Sunday Leader of his own experience. After suffering from chest pains whilst on safari in Sri Lanka’s deep South, he was advised to get his heart checked out. Eventually it was decided that he needed a simple procedure called an angiogram. He chose a cardiologist Dr Vajira Senaratna. During the time that the procedure was being carried out Dr Senaratna had informed his patient that although ‘this procedure’ would do, he could if the patient wished, have a ‘stent’ put in. This is a more involved procedure than an angiogram and clearly costs more. On inquiring about the cost of such a procedure, Dr Senaratna had said ‘around a million’. Whilst the patient who was on the table contemplated this, he was offered the services also of a Mark Silvestri who he said was a reputable man in the field, and a Frenchman to boot.
    On being asked if Mark Silvestri was a registered practitioner in Sri Lanka he was told, ‘oh, it’s ok if he is working with me it is ok’. For a man who had spent 37 years of his working life in Europe and more used to adhering to the rules and procedures in place, it struck him that Dr Senaratna was not only trying to sell a service which by his own admission was not essential (but could help) but was also being rather flippant about the regulations – and therefore respect for the rules in Sri Lanka – applying to foreign doctors practicing in Sri Lanka, however suitably qualified they may be.
    Incensed by this almost callous attitude especially over the timing of the offer of putting in a stent – at considerable cost – which Dr Senaratna was careful to qualify by saying was not essential but could help, Dr Thenabadu complained to the Sri Lanka Medical Council (SLMC). Initially, by letter dated January 1, 2013, Dr.Thenabadu was told by Dr N. J. Nonis the Registrar that Dr Mark Silvestri was not registered with them. He had also stated that he had written to the hospital asking if such a person had practiced there. The complaint against Dr Senaratne was referred back to Dr. Thenabadu asking him to have the complaint resubmitted in the form of an affidavit.
    Subsequently by letter dated January 23, 2013 enclosing a letter from the private hospital, the SLMC confirmed that Mark Silvestri was on a private visit and during that time had been asked to demonstrate the use of a rotablator. The SLMC confirmed that though he was not temporarily registered at the time on a previous occasion he had been an observer and advisor with temporary accreditation.
    Dr Thenabadu of course chose not to have the stent inserted.
    However for Mrs. Matyana Rupasinghe matters ended disastrously with her untimely demise. She had consulted Dr Senaratne who had advised her to have a stent inserted. There have been unconfirmed allegations that Dr Senaratne directly or indirectly represented a company supplying stents. To those like Dr Thenabadu this appeared to be a conflict of interest if indeed Dr Senaratna was representing the company supplying stents. Whilst there is absolutely no inference that Dr Senaratne was the cause of Mrs. Rupasinghe death, sources close to her family have indicated that Dr Senaratne treated her high sugar levels at the time with a dose of insulin and was ‘hell bent’ on carrying out a procedure to insert the stent as well.
    Whether Dr Senaratne ever used the services of foreigners visiting Sri Lanka privately is not clear. In the case of Mark Silvestri however we have an indication of the rather grey area that has encompassed the process of registering foreign doctors practicing in Sri Lanka – before they can go ahead and treat patients in Sri Lanka at huge cost – many times above what a Sri Lankan specialist would charge.
    The SLMC claims that the procedure and process is simple. However after some palpitations the process of registering a foreign doctor is carried out by a Committee which will decide on whether the particular doctor is suitably qualified and experienced. The Committee was established after it was found that many foreign doctors remain in Sri Lanka just for a short period and are not always available for aftercare. Many patients would prefer continuity with the doctor of their choice and for whose services they would have paid significantly more in any event.
    Dr Thenabadu spoke of a need to tighten up the process and its enforcement. The current flippant ways must be addressed as a matter of urgency he urged. In Sri Lanka with its penchant for valuing things foreign far higher than anything local, the quest to ensure firm commitment from foreign doctors in terms of aftercare and also suitability, is likely to be a long and arduous task.
    (faraz@thesundayleader.lk)

  33. Hi Isuru

    Thanks for sharing this experience with us. It will be helpful for the other patients who are going to consult him.

  34. mans sarpens says:

    Hi
    Thanks for sharing. Medicine is changing now a days…I know. I am a cardiologist and see how some colleagues push for procedures to make money. I find this distasteful and unethical. I have started to create websites to create awareness to patients regarding these bad times. My first site is one dedicated for patients who will undergo cardiac procedures. Feel free to refer for information. More websites to come…

    Best Regards,
    MS
    http://www.myheartprocedure.com

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: