Valve and oxygenator shortage affect cardiac treatment

A severe shortage of artificial heart valves and oxygenators, which is crucial for a number of surgical procedures including valve transplant and open heart surgery, is affecting cardiac treatment at the hospitals of the country.  

As a result, no valve transplant has been done at the National Heart Foundation in the last one and a half months. Meanwhile at the National Institute of Cardiovascular Diseases (NICVD), the valve shortage has eased a little but the oxygenator shortage persists disrupting paediatric cardiac surgeries, open heart surgeries and valve replacements.

Oxygenator is a medical device that replaces the heart's functionality during open bypass surgery allowing surgeons to operate on a stationary heart.

Supply of both oxygenators and artificial valves are import-dependent and a raw material crisis in the wake of the Ukraine war has interrupted the production of these devices. Besides, due to the existing LC complications, importers are unable to import as per their demand. As a result, the treatment of cardiac patients is seriously hampered and they are facing an increased risk of death.

Requesting anonymity, a doctor at the National Heart Foundation, told The Business Standard that all hospitals are facing the shortage and they are forced to send back the patients home.

"The valve crisis has been there for the last three months. One of the companies brought in 80 valves, which helped a little. Another company brought a few valves this month. I'm not sure how many patients can be treated with those," said the doctor.

"Due to the valve crisis, treatments of many patients are halted. There are many patients who immediately require valve replacement. If not replaced quickly, there are many patients who may not survive," said the cardiac surgeon.

More than 1,200 heart valves are replaced in Bangladesh every year and on an average 100-120 valves are required in Bangladesh every month.

Importers said they import heart valves and oxygenators from Japan and the United States. The manufacturers procure the raw materials for making these devices from Belarus, Ukraine and Russia. The Russia-Ukraine war has caused a roadblock in procuring the raw materials.

In Bangladesh Unimed Limited, Space Med Enterprise, Biocard Ltd, Cardiohelp Limited and Spondon Ltd supply heart valves and oxygenators.

Wishing anonymity, a director at one of the suppliers, said that they import valves from Abbott Laboratories, which is an American multinational medical devices and health care company

"They are not able to supply as per our demand. One of the raw materials for heart valves is pyrolytic carbon, which is found in Ukraine, Russia and Belarus. Due to the war there is a shortage of raw materials. Besides, production was stopped for two years due to Covid. We have many orders placed but they are not shipping it. Then there is the issue of opening LCs," the supplier elaborated.

"Doctors are now giving our phone numbers to patients to inquire about valves. There is not a day that 50 patients do not call," the supplier said, adding that their supplier said the crisis of valves will ease by the end of December or January while the oxygenator shortage will not improve before March.  

Professor Dr Mir Jamal Uddin, director of NICVD said, "We now have few valves in hand. But the main problem is the oxygenator. The suppliers have informed us in writing that they are unable to supply oxygenators for now."