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Structural and Congenital Cardiac intervention Research work in Bangladesh 3rd Edition
PREFACE TO THE FIRST EDITION
When I decided to go to Prince Sultan Cardiac Centre (PSCC), Riyadh, KSA in 1996 for training in pediatric
cardiology, my friends and relatives strongly opposed my decision. At that time, this subject was completely
unknown to all of us and we had limited idea on few cases of Atrial Septal Defects, Ventricular Septal Defects
and Tetralogy of Fallots with complications which were only seen in BSMMU, CMH Dhaka, DMCH and NICVD
during our training period in FCPS course. So selecting such an unknown subject with doubtful future prospects
and leaving behind a bright future as a pediatrician was really a very challenging and tough decision.
Prince Sultan Cardiac Centre is a very busy and advanced cardiac centre in KSA and with my little knowledge
of modern paediatric cardiology I was totally lost in first few days of my training. Then I took the job as a
challenge, worked hard round the clock to cope with the activities of the centre as a responsible registrar of
one of the unit.
At one stage I became sick and gave birth to a preterm and extremely LBW baby . I was suffering from HELLP
syndrome, we both were fighting for our own life in two separate ICU. Everyone were blaming my overwork and
exhaustion for the complications.
Both of us survived by the grace of almighty and I decided to sacrifice my extended life for pediatric cardiology.
I returned back to Bangladesh in late 1998 and tried my level best to establish a pediatric cardiac centre in my
hospital. I left no stone unturned to spread message to all concerned people/ hospitals/ specialist doctors that
congenital heart disease is a serious health problem which needs to be addressed properly.
I remember the contribution of Maj Gen(Retd) Amir Ali (Ex Consultant Surgeon,Bangladesh Army), Maj Gen(Retd)
Mosaheb Hossain (Ex Director General Medical services), Maj Gen (Retd) Ziauddin Ahemed (Ex Consultant
Physician Bangladesh Army) for giving me all out support to achieve my goal. I also remember the contribution
of Maj Gen (Retd) Moyeed Siddiqui for giving me moral support since the time when he was Chief Physician of
CMH Dhaka. I also remember the contribution of late Col Quazi Shafiuddin Ahemed who has given me utmost
guidance and protection. I also express my gratitude to Maj Gen Rabiul Hossain, consultant physician of
Bangladesh army for his encouraging advice.I am grateful to col Mamunur Rahman , Head of Cardiology, CMH
Dhaka for his moral support and help specially during the visit of foreign experts in training program. My
gratefulness is for all patients and their parents who has trusted me to work on them/ their child with new ideas.
Lastly I am extremely grateful to my family members who sacrificed a lot for achieving my goal.
Now Paediatric cardiology unit of CMH Dhaka is the only unit of the country where all kinds of congenital
interventions are performed not only for the army persons but also for the civilian patients with special permission.
We are the pioneer in all the life saving and curative interventions in the country. Moreover we are giving training
to the doctors to establish pediatric cardiology unit in other hospitals.
I hope this book will provide the readers the information about the first ever case reports of various congenital
interventions in Bangladesh along with description of procedures. Various research work on congenital heart
diseases are also included in the book.
This book will also provide informations to future Pediatric Cardiologist about the history of the subject in
PREFACE TO THE SECOND EDITION
In the five years since the first edition of this book was published I have received numerous email, messages
and letters from readers commenting onthe book and suggesting how it could be improved. I have also built upa
large file of ideas based on my own experiences in reading, writing, andediting and in examining and supervising
these. With the aid of all thisinformation I have completely revised the book. The most obvious changesin this
second edition are the new articles and case reports.
Working in the field of Paediatric Cardiology and Intervention was never tiring and boring subject for me rather
it has become a passion for me to think about new ideas and to explore it with all the logistic support I have in
my hand. Sometimes I find my path a bit hectic and choppy, but with the kind help of Almighty Allah I could
overcome all these troubles.
My aim to give my all research works a shape was to share my experiences with expert in this field, to help
newcomers and to keep all together for future reference.
Almighty Allah has given me the opportunity to start most of the Pediatric Cardiac Intervention in Bangladesh
like first ever Balloon atrial septostomy and PDA coil occlusion in 1998, Pulmonary vulvoplasty in 1999, ASD
device closure in 2000, VSD device closure in 2002, Muscular VSD device closure in 2004, PM VSD device
closure in 2005, PDA and RVOT stenting in 2006, coronary fistula occlusion in 2007, coarctation stenting in
2009, VSD closure, PDA closure in newborn with ADO II in 2011. I also got the privilege to start PPVI first ever
in South Asia on 25 Dec 2012. 2nd PPVI program was successfully completed on 1st Jan 2014 without the
help of any proctor/ foreign assistance. Our last PPVI program was successfully completed on 10 Oct 2016,
and till now PPVI is not yet started in any place of South Asia.
I always tried to find a way to help my poor patient and in 2014 I could establish a contact with King Faisal
Research Hospital, KSA. Our first charity mission was successfully completed in Oct 2014 where total 19
patients underwent cardiac surgery and 21 interventions were done all of which were free of cost. Then
subsequently we completed 2nd and 3rd mission in Feb and Nov 2015 respectively where almost 200 patients
got treatment without any cost (worth 8 crore taka). In every case financial support was given by Al Muntada
Aid, UK and infrastructural support was given by CMH Dhaka.
I personally raised a fund in the name of my parents (WADUD-MAIMUUNESSA FOUNDATION) to help poor
and needy people. This foundation also select one Pediatrician once in every two years and provide gold
medal for his/her glorious performances in the field. Some are shown honor with prize money.
With the blessing and guidance of respected national professor M R Khan I took the initiative to open a trust for
pediatric cardiac patient in 2014 which was named ‘Child Heart Trust, Bangladesh’ which is composed of so
many renowned cardiologist and cardiac surgeon of Bangladesh.
I have tried to share all the experiences I gained from my above works. I found so many well-wisher beside me
in achieving my goal like Chief of Army Staff and Adjutant General of Bangladesh Army, DGMS and Consultant
Physician General of Bangladesh Armed Forces, Commandant and Chief Physician of CMH Dhaka, my fellow
colleagues and my all students.
Foremost of all, I gratefully acknowledge those closest to me –my families, my life partners, and, of course, my
two lovely daughters. I owe them much for their patience, guidance, camaraderie, and, most of all, their love.
PREFACE OF THIRD EDITION
When second edition copies were finished and question of reprint arose, I though better to add some articles
and events which were published and happened after printing of 2nd edition. The big event was
independence award 2019. I received this highest civilian award from honorable Prime Minister Sheikh
Hasina on 25th March 2019 for contribution in the field of Medical science. This award increases my
responsibility to many fold to work hard for the children with congenital heart disease. I can assure that I will
try my level best to contribute for my country to improve health care status of children specially with
congenital heart disease. In November 2019 , on the occasion of Armed Forces day, I was awarded with
prestigious “ Shena Bahini Podok” which is the highest piece time award of Bangladesh Army.
Working with children of congenital heart disease is my passion. During my long journey of work with
congenital heart disease since 1996, I have learned many difficult interventional techniques, special skills ,
tried my level best to remain empathetic to my patients and parents. My long experience of work with a
difficult topics of children and cardiac intervention enabled me to adopt few motto’s in my life to practice and
to disseminate to my students and followers :
1. “Listen more, treat less” : for pediatrics
2. “Do not harm, if not good ” : for interventional pediatric cardiology
3. “Know your equipment, then use for the patient” : for intensive care unit
I am grateful to Maj Gen Fashiur Rahman MBBS, MPH, MBA, FCGP, MSS, LLB, SPP, ndc, PhD for his whole
hearted support and help in all my activities, which in turn enabled me to achieve highest civilian award of
the country. His guidance and leadership is unforgettable. I am ever grateful to Gen Aziz Ahmed BSP,
BGBM, PGBM,BGBMS, PSC, G Chief of Army Staff for his precious support to under command for state of
the art performance in own field. His inspiration and recommendation enabled me to achieve “Shena bahini
Podok” 2019. I am indebted to him for including me in his good list.
I am grateful to all my patients and parents who had given me the opportunity to work with them, treat them,
followed them up in time which in turn enabled me to achieve skill and perfection. My colleagues of
department of Pediatric Cardiology and cath lab were always with me in my good and bad time, their
camaraderie in some night mare cases in Catheterization Laboratory has given me huge moral strength
always. I am ever grateful to them. Lastly I am indebted to my family members who has given me enough
freedom to work with highest professionalism without engaging me in routine issues. I missed them often
but smile of my cured patient is the best reward for me to move on.
Professor Nurun Nahar Fatema Begum MBBS, FCPS, FRCP, FACC, FSCAI
Interventional Paediatric Cardiologist, Advisor and Head
Department of Paediatrics
Combined Military Hospital Dhaka