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With enough anesthetists, each surgeon will have at least three operating sessions per week. Proper patient counseling preoperatively and effective communication with our cardiology team also help to reduce this undesirable outcome. For those unstable, symptomatic and deteriorating patients, we will keep them in the ward for stabilization and operation before discharge. However, we have taken every possible effort to avoid this from happening to our patients.

I donвЂ™t think there is any single cardiac centre in the world can promise or achieve zero mortality in waiting list. We donвЂ™t have the exact figure for this group of patients but we believe this involves a very small number of patients, probably less than five patients a year. FPP will also help in increasing our output by adding extra operating times after office hours. We are running two OT simultaneously whenever we have two anaesthetist to increase the output. We have been referring those high risk patients regularly to IJN. We have taken several measures to overcome this problem. We are taking up more complex, high risk and unstable patients who required more urgent attention and this had disrupted our normal elective waiting list. Their waiting time for Cath lab has increased from two weeks to three months. As we know, they are our main source of patients. This can be reflected by our cardiology teamвЂ™s increments in workload as well. Other than the shortage of cardiac anaesthetist which resulting in the decline of the output, the overall workload has also been increasing tremendously over the years. This is fairly reasonable waiting time as Serdang and Penang Hospital also has similar length of waiting times, 6-9 months.

Total out patients waiting for surgery 223 patients With the arrival of our third anaesthetist, we can aim to achieve 350-400 cases in 2015. We were actually targeting to achieve 400 cases in 2014 but the severe shortage of cardia anaesthetist had resulted in the decline of the number of cases. 2014 - 250 patients (three surgeons, two anaesthetists)ДЄs we can see, our cases had increased steadily from 2011-2013. 2012 - 296 patients (two surgeons, three anaesthetists) 2012 - 260 patients (one surgeon, four anaesthetists) 2011 вЂ“ 168 patients (one surgeon, four anaesthetists) Luckily MOH has been very kind and sympathetic with our problem and we had our third anaesthetist, Dr Hasmizy joined us on March 2015. We had been regularly updating Datuk DG regarding our problem too. We had taken several measures to overcome this shortage and these included engaging two private anaesthetist to do sessional work in our hospital namely Dr John Chew and Dr Nora. Sadly, Dr Thanasi had suffered two heart attacks while he was trying very hard to cope with three surgeons in 2014.

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During this period of time, we actually had only one full time anaesthetist, Dr Hanafi as Dr Norzalina is our state anaesthetist and she is very busy with her administration works. Even though the number of surgeons had increased from one in 2009-2012 to three since 2014, the number of cardiac anaesthetist had declined from the maximum of four down to two only from October 2013 вЂ“ February 2015. Three cardiothoracic surgeons- HOD: Dr Jong Yuan Hsun since 2009Д¬ardiothoracic surgery requires team work. In response to the query in Parliament, we wish to put forward the following information to clarify this matter. Patients dying in SвЂ™wak Waiting for SurgeryДr Jong Yuan Hsun (Head Department of Cardiothoracic Surgery Pusat Jantung Hospital Umum Sarawak)

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