Tengis Shiryaev – We can determine exactly which heart defect to treat, how and at what time, we know in advance what the child’s health will be and what status he/she will have in 20-25 years – this is the greatest medical discovery of this century…

I may say with full responsibility, that child’s as well as adult cardiac surgery is as well developed in Georgia, as in any other part of the world – says pediatric cardiosurgeon, Tengiz Shiryaev,   the Head of the Department for the Congenital Heart Defects of the JoAnn University Hospital.

1. Several years ago the phrase “your kid has  congenital heart defect” was a kind of verdict, that did not allow to make any optimistic prognosis; what has changed and what reality do we have in this regards  today?

First of all, congenital heart defects are characterized by anomalies of heart development,  i.eduring intrauterine period the heart – heart structure, septa, valves and vessels located near the heart  were formed anatomically incorrect. Congenital heart defect is the most common anomaly among congenital defects. Of course, mentioned above phrase was always scary to both  the parents and the community because it meant a very poor outlook for the child; although the situation has significantly improved during last 50  years. Profound knowledge and experience has been accumulated in this regards globally; Technologies have developed at an enormous speed. As a result, we can easily treat the conditions  and a child born with congenital heart defect will be transferred into the healthy category for the rest of his/her life.

Segmentation isalso  important, as there are congenital heart defects, that can be easily fixed with one or two surgical  interventions, after these interventions children are no longer even limited to professional sports. However, there is a small number of defects,  when patients need several operations, such patients are encouraged not to be engaged  in high-traumatic or high-intensity sports, although playing and jumping with friends is certainly not prohibited. This  is the greatest achievement in medicine in this century.

2. This greatest achievement in medicine  resulted of what? Is it at the expense of technology development? Or, in general,  at the expense of awareness and information?

Of course, this was predetermined by the development of new technologies, though, to a  large extent it was the result of the knowledge and experience accumulated by  pioneers and great scientists. Later knowledge accumulated turned into experience, and today we can accurately determine how and at what term each defect should be treated and what outcome should be expected;  we know in advance what the child’s health will be and what status he/she will have in 20-25 years.

3. If a child has a congenital heart defect (that, as you have mentioned, due to various factors can be relatively easily corrected)does your medical Institution provide medical surveillance for next 20-25 years?

I will repeat here, that it depends on the type of congenital heart defect the patient has. For us, for the society, congenital heart defect is  a catch-all phrase, although congenital heart defect enrolls many variants –  from a very simple to a catastrophically complicated  situations. Most of our main interventions are cases when we do  one operation, and then the child  stays healthy for the rest of his/her life. Though there are defects when once a year follow-up to observe the dynamics, or to plan another operation or non-surgical intervention is necessary.  Non-sergical interventions have developed a lot during recent years, both in our country and around the world, But control is very important.

4. In case of congenital heart defects majority of interventions are surgical, are not they?

So far, yes, they are

5. Do new highly developed technologies help you and make your work easier?

Modern technologies make it possible and easier for us to perform complex, large-scale operations in newborns, pre-term and underweight patients. Of course we could never perform these interventions only with our determination or desire. For this very modern and highly developed technologies are needed.

6. Previously there was knowledge and experience, but no instrumental possibilities to perform such large-scale interventions.

For centuries they want to perform similar operations, though there was no appropriate equipment, and it was not possible. Each field of medicine has its specifics, for those outside, it looks very romantic when you perform operation on a small child’s heart. All around the world such operatios are  an accepted practice.

7. The Hospital you represent has been one of our top cardiac facilities since 1990-ies. You were discussing development of medical means to fight congenital heart failure, Such evolution is understandable and logical. In developed countries together with modern technologies, advanced and successful practice is then spread  and shared with colleagues.   What about your hospital, do you have such an experience, and what happens locally?

In 1996 JoAnn Medical Center  was opened in Georgia. Before that operations on congenital heart defects were performed in our country. However, they were performed only in one hospital   by visiting surgeons – selected operations, only for selected patients

After the establishment of the Medical Center named after Jo Ann, a unified system for treatment of congenital heart defects  was created, such system did not exist neither in Georgia, nor in the region.Therefore, since 1996 a larch-scale approach to solving the problem was initiated. Initially the Hospital was opened only for small children with congenital heart defects. All this happened as a result of a lot of efforts and with the direct involvement of an American philanthropist, Mrs Jo Ann McGowan and her great wish that no more child died of heart defect.  The last period of her life was dedicated to this great problem. It was a joint project between American and Georgian governments, and the result of great friendship between the two countries. The leading specialists in the field from the Stanford Children’s Hospital came to the newly opened Joe Ann University Hospital and were actively involved in the implementation of the system.  With the help of America the latest equipment, funds, all necessary inventory were mobilized at that time. Since then knowledge and experience were accumulated, the work continues to this day, we try not to stop, not to lag behind the development of modern medicine in the world; for this quality control and implementation of innovations are necessary.   In this regards, we are involved in two big Programs.One is Boston Children’s Hospital Program, that is focused on quality control, and we are also involved in the Common European Database on Congenital Heart Defects. This means that we are constantly monitoring and improving our work, and continually thinking of quality improvement. That is why it is so important to follow step-by-step development of modern medicine.

8. Today many Clinics are opened, other clinics also work on the problems of work on the problem of congenital heart defects in children, as you Hospital is a specialized medical institution, you have a special comfort zone for patients and for health care professional who pergorm surgical interventions.

We work 24/7  and main field of our work are congenital heart defects and the ways of their treatment. Of course other services are also provided,so that patients have access to specialists  working in the various fields. For more than 25 years we try to make our patients feel comfortable, and receive all the necessary services in one environment and space .

9. In your opinion, how modern is medicine in your hospital, even in terms of combating congenital heart disease?

I can very boldly answer this question – today cardiac surgery for children and adults in Georgia is brilliantly developed, and any heart-related problem can be solved here the way it can be solved  in any leading hospital in Europe and America.It did not come by itself and is the merit of great people, the pioneers who said their word in the development of cardiac surgery in Georgia.  They have put a lot of work, so we could get these results today. My teachers had the honor to have the world’s best specialists as their teacher; to bring them to Georgia or to visit them to get profound practical knowledge in the field. Therefore, the answer to your question is – with full responsibility I can say that  pediatric an adult cardiac surgery  is as well developed in Georgia as in any other part of the world.