'I always aspired to be a consultant back home'

A recruitment embargo is preventing highly trained cardiologist Dr Ronan Margey returning home

Hurricane Sandy at the end of October was one of the most devastating natural disasters to ever hit the United States. It left a trail of destruction in 24 states along the eastern seaboard and 253 people dead.

Though the destruction was terrifying, there were many tales of heroics and survival against the odds.

Letterkenny native Dr Ronan Margey (34), a cardiologist and assistant professor of medicine, was on duty in Hartford Hospital, Connecticut, shortly after the storm when a 64-year-old man presented with a heart attack.

It was the man’s third heart attack in less than 10 years and he was gravely ill.

Dr Margey opened up the blood vessel that was blocked resulting in the heart attack, but a huge amount of damage was done to the right side of the heart. The man was given drugs for his blood pressure and a mechanical device to help his blood flow, but his condition continued to deteriorate.

Grim prognosis

Unusually, the heart attack predominantly affected the right side while all the regular methods of support are designed to help the left side of the heart.

His heart condition could have led to multi-organ failure as the organs shut down due to the lack of blood supply.

Dr Margey said he had “less than a 50:50” chance of survival. “His prognosis was very grim.”

The right side of the heart pumps blood to the lungs where it returns oxygenated to be pumped around the rest of the body by the left side.

“Because you are not able to get adequate blood returning to the left side of the heart, the patient’s blood pressure and ability to perfuse all the other organs of the body starts to become compromised,” he explained.

“Up to now there was no dedicated treatment. We tried to do our best with the medications and technology we had with the hope that the heart would recover over time.”

Through his work as a cardiologist, Dr Margey had heard of an experimental percutaneous (inserted through the skin in the groin) right mechanical heart device made by Abiomed, a Massachusetts medical devices company which has a facility in Athlone.

The mechanical heart device had previously been used only eight times worldwide, seven times in Canada and once in Switzerland, however, it had not yet been approved by the Food and Drug Administration (FDA) in the US which sanctions medical devices.

A similar device had been used for 10 years for the left side of the heart but one has only been developed for the right side recently because acute heart failure from the right side of the heart is less common.