February 25, 2000

Coronary artery disease has become a growing problem among China's 1.3 billion residents — one that the country's medical professionals have not been equipped to address. Recently, however, the Chinese government and military have reached across their borders to learn more about the treatment of heart disease.

Through an international health education organization called Project Hope, a team of MGH cardiac surgeons, cardiologists, nurses and technicians visited the Second Military Hospital in Shanghai, China. During a 10-day period in November 1999, the MGH team headed by David Torchiana, MD, chief of MGH Cardiac Surgery, evaluated 22 patients, performed 11 coronary bypass surgeries and gave daily lectures to hospital personnel.

"It was an incredible experience, and we were well received," says Marc Semigran, MD, an MGH cardiologist who went with the team. "They seemed excited to have us there and learn from us, and we learned from them too."

Chinese clinicians move in closer to watch MGHers at work.

The MGH team included Torchiana, Semigran, Michael D'Ambra, MD; Arvind Agnihotri, MD; Barbara Hill, RN; Catherine Griffith, RN; Lisa Carr, RN; and Gerard Pelligrini. The MGH team got involved with Project Hope through David Adams, MD, associate chief of Cardiac Surgery at BWH, who has led BWH medical teams to several Chinese hospitals over the last two years. According to Torchiana, this Project Hope initiative was designed to bring a higher level of expertise to both the catheterization labs and cardiac surgery practices in five major centers in China.

"China has a growing mortality rate from coronary artery disease as the country is becoming more westernized," says Torchiana. "While the surgeons are expert in valve surgery, they have very little knowledge of coronary bypass surgery. The Second Military Hospital, which is the busiest heart surgery center in Shanghai, had done fewer than 100 coronary artery bypass graft operations in the last 10 years."

According to Semigran, the MGHers helped the medical staff identify candidates for coronary bypass surgery and taught them how to care for patients before and after their operation. They also accompanied the Chinese physicians on their rounds in the intensive care unit, and Semigran performed some cardiac catheterization procedures.

"They were knowledgeable in the basic science of medicine, but when it came to application of that knowledge on the ward, they lacked the level of experience that we have," says Semigran. "We tried to help them bring more organization to their clinical practice and think of problems in a more systematic way. They were very appreciative of our help."

Despite the significant language barrier, the local hospital staff seemed interested in what the MGH team had to offer. "They were very willing to try our suggestions for new techniques," says Catherine Griffith, RN. "They were very attentive and extremely meticulous in their care of patients."

The MGH team plans to return to China for a follow-up visit in the near future.