The last mile of medical care localization. Tri-Service General Hospital (TSGH) Penghu Branch performed the first open-heart surgery in outlying islands.

A 75-year-old male had repeat symptoms of shortness of breath and lower limbs edema since July 2021. After several admission and a series of examinations, valvular heart disease with congestive heart failure was diagnosed. The result of medical control was poor so surgical intervention was indicated. Due to personal reasons, the patient requested surgery in the local hospital. With the full support of the Medical Affairs Bureau and Tri-Service General Hospital, we gathered a cardiovascular surgery team including surgeons, anesthesiologists, and nursing staff from TSGH Taipei and Penghu Branch.

Local cardiologist Dr. Chang arranged a complete coronary angiogram before the surgery and luckily this patient didn’t need coronary bypass surgery at the same time. Team leader, Deputy Surgeon General Professor Tsai did a full-scale inspection and physical exam personally and set up the surgical plan to replace the mitral valve and aortic valve and repair the tricuspid valve along with electro-ablation of atrial fibrillation. The total surgery time was 7 hours and 4 minutes.

The patient was transferred to ICU for monitoring and post-operative care. The heart function improved gradually and the course of the weaning ventilator was uneventful. He received breath and exercise rehabilitation during the hospital course and the symptoms of shortness of breath and limbs edema diminished.

Presenting the best quality and localized medical care is the goal of the Medical Affairs Bureau, Ministry of National Defense, and Tri-Service General Hospital. It is a great honor and privilege for the TSGH Penghu branch to set up this milestone of the first open-heart surgery. The great result depends on the efforts of all successive Surgeon Generals, superintendents, and local staff. We will keep providing timely, adequate, and quality healthcare services to all uniformed service members and people in Penghu County.