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Durdans Heart Centre performs five successful TAVI cardiac procedures for the first time in SL

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Durdans Heart Centre has reached a landmark by performing five successful TAVI (Transcatheter Aortic Valve Implantation) cardiac procedures, while the patients were under local anaesthesia, for the first time in Sri Lanka.

Dr. Pandula Athauda-Arachchi became the first Sri Lankan, fully independent specialist to have implanted TAVI valves under this procedure. He is also credited with implanting devices in t0wo different platforms and performing Sri Lanka’s first TAVI for morphologically abnormal bicuspid valves as well as the normal tricuspid valves.

The aortic valve plays a key role in the body’s blood pumping mechanism. It’s failure causes chaos in all the vital organs. Factors such as age-related wear and tear or defects from birth can cause the aortic valve to narrow, restricting blood flow which deprives the rest of the body of oxygen.

Dr. Athuada-Arachchi explained that the Transcatheter Aortic Valve Implantation (TAVI), with meticulous pre-planning, enabled him to replace the valve within 90 minutes in certain cases. Despite operating on high-risk individuals, it reduces the risks associated with open-heart surgery and general anaesthesia. It involves carefully choosing and placement of a balloon-expandable (MyVal or Edwards) or self-expanding (Medtronic Evolut™ R) transcatheter aortic heart valve after precise crushing off of the diseased valve leaflets.

Every year, many such patients who need an aortic valve replacement, are deemed to be of high risk, will be turned down for open-heart aortic valve replacement surgery and eventually end up with prolonged heart failure or sudden death.

Due to innovation and progress in the medical industry and skilled medical specialists over the last few years, this unmet need for high-risk valve replacement has become simpler and safer with the use of TAVI.

The procedure is performed by inserting a catheter with the valve into the body through a small incision and navigating it to the affected valve, the patient remains fully conscious during the procedure, which only lasts about 90 minutes. TAVI allows for a shorter recovery time, mobilisation within 24 hrs and reduces the risk of infection, stroke, need for dependence on ventilators. Typically, despite their age or multiple medical issues, patients can be discharged from the hospital in three days.

Recently, TAVI was performed on two elderly patients at the Durdans Heart Centre.



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Police failure to contain May 2022 violence explained

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Police inaction to prevent arson attacks against SLPP politicians in the Western province on May 9 may have been due to orders not to carry weapons to deal with protesters, a new investigation has revealed.A review of the role of the police at the time showed Senior Deputy Inspector General Deshabandu Tennakoon had ordered all officers under him to ensure that no personnel were issued with arms and ammunition in the run up to the May 9 violence.

In his two-page instructions to DIGs, SSPs, SPs, ASPs and officers in charge of all stations in the districts of Colombo, Kalutara and Gampaha, Tennakoon had said no weapons or ammunition should be issued under any circumstances to officers deployed to deal with the protesters.

This order dated May 5 had not come to the attention of a three-member investigation panel headed by former navy chief Wasantha Karannagoda appointed to look into the security lapses. However, the panel had uncovered an order similar to that of Tennakoon issued by the then army chief Shavendra Silva.

Deploying police without even their own personal protection is seen as a violation of departmental orders and an internal investigation had begun, a top official source said.Meanwhile, the private residence of President Ranil Wickremesinghe was torched despite 400 air force men being deployed to protect it. The airmen did not open fire to deter a handful of attackers who scaled walls to enter the premises and set it on fire.

Instead of dealing with the arsonists, a police Special Task Force (STF) unit outside the Fifth Lane residence of Wickremesinghe attacked a television crew angering the protesters and encouraging more people to congregate there.

Several people identified through CCTV footage have already been arrested in connection with the arson at Wickremesinghe’s residence.However, action is yet to be taken against police and security personnel who failed to ensure law and order.

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SL will engage major T-bond holders for voluntary optimization: Governor

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ECONOMYNEXT –Sri Lanka will not re-structure Treasury bills outside of central bank holdings and will engage with major T-bond holders for voluntary ‘optimization’ Governor Nandalal Weerasinghe said.

“There will be some treatment on central bank held Treasury bills,” Governor Nandal Weeasinghe told a creditor presentation Thursday.

“Other Treasury bill holdings will not be treated. Treasury bonds we envisage voluntary optimization.”

Sri Lanka has to at least extend the maturities of bonds to reach a gross financing need target averaging 13 percent of GDP in 2027-2032 based on projections in an IMF debt sustainability analysis. Of that foreign debt service has be below 4.5 percent of GDP on average.

“Local currency creditors participation in a debt optimization will help reaching the DSA targets,” Treasury Secretary Mahinda Siriwardena said.

“Authorities are exploring options for domestic debt operations aimed at liquidity relief while preserving financial stability to avoid further eroding Sri Lanka’s repayment capacity.”

The government and advisors will “invite consultations with major T-bond holders to gauge options and constraints”, he said.Governor Weerasinghe and Treasury Secretary Mahinda Siriwardene said Sri Lanka is likely to outperform the growth targets in the IMF debt sustainability analysis given past history. The IMF DSA is projecting 3.1 percent growth in the next few years.

Sri Lanka grew at rates around 4 to 5 percent during a 30 year war, but growth started to fall after serial currency crises hit the country under flexible inflation targeting with output gap targeting (monetary stimulus) during peacetime. In 2020 taxes were also cut for stimulus, going beyond open market operations and outright purchases of bonds seen earlier.

Meanwhile state spending went up from 17 to 20 percent of GDP under state expansionist revenue based fiscal consolation after spending based consolidation (cost cutting) was thrown out of the window from 2015 to 2019, critics say.

Sri Lanka is now trying to cut spending and excessive growth of the public sector, based on normal economic principles, to limit the burden of the unaffordable state on productive sectors and the poor, while preserving essential spending.According to the latest IMF program, fiscal consolidation will be “primarily” revenue based.

Sri Lanka’s Treasury bill and bond yields were higher than required due to uncertainty over whether they will be re-structured and the so-called ‘gilt’ status will no longer apply.

The lack of an early cut off date for domestic debt is a key problem in the IMF’s current debt resolution framework as domestic bond buyers are the last resort lenders after most foreign creditors stop lending, when the IMF says a country’s debt is no longer sustainable.

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Sri Lanka and debt advisors will engage with major Treasury bond holders, Weerasinghe said.

Key T-bond holders are Employment Provident Fund, Employment Trust Fund, insurance companies and banks.

Sri Lanka is also conducting an asset quality of review of banks.

Based on its results a debt optimization options will be offered paying attention to asset liability mis-matches, Weerasinghe said.

By preserving banking sector stability foreign investors are more likely to get repaid.

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BASL slams attempts to hinder Saliya Pieris, PC, appearing for a client

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The Bar Association of Sri Lanka (BASL) has issued a statement on the recent string of protests launched against former BASL President Saliya Pieris’s decision to represent a client who had retained him. In the statement signed by BASL President Kaushalya Nawaratne and Secretary Isuru Balapatabendi, the BASL noted that the protests in question not only hinders the senior lawyer’s right to represent a client, but also acts as an attack on the profession at large.

Further, they noted that Article 13(3) of the Constitution of Sri Lanka specifically guarantees every person the right to a fair trial and the right to be represented by a lawyer of their choice.

The BASL also cited the 2019 Supreme Court judgment delivered in a landmark case together with the Judicature Act, the Code of Criminal Procedure and the Civil Procedure Code in favour of their argument. The Bar Association strongly demanded that the relevant authorities ensure that Pieris’s professional duties and safety remain unhindered.

Excerpts from text of the statement:

“The Bar Association of Sri Lanka (BASL) observes that there has been a series of organized protests in Colombo, in relation to Mr. Saliya Pieris PC, the Former President of the Bar Association of Sri Lanka, conducting his professional duties with regard to a particular client.

“We are of the view that the said protest, not only seriously hinders his right to represent a client, a professional right which has been safeguarded by law, but also an attack on the profession at large.

“In the case of Wijesundara Mudiyanselage Naveen Nayantha Bandara Wijesundara v Sirwardena and Others (SCFR 13/2019), the Supreme Court observed that: ‘The first piece of legislation passed by the Parliament soon after the promulgation of the 1978 Constitution was the Judicature Act No. 02 of 1978.

‘As the administration of justice in any civilized society cannot be effectively implemented without lawyers, the legislature in its wisdom, through the Judicature Act, established the legal profession. Thus, there is no dispute that the legal profession is a sine qua non for the due administration of justice in this country and for that matter in any civilized society. The said profession is essential for the maintenance of the Rule of Law and maintenance of law and order and its due existence is of paramount importance to the organized functioning of the society which is primarily the basis for the smooth functioning of the country as a whole.’

“Our constitution specifically guarantees the right to legal representation in Article 13(3) and

the Civil Procedure Code also provides for the right to legal representation in civil cases. Specifically, Section 24 of the Code allows parties to be represented by lawyers or other authorized representatives in court.

“Overall, Sri Lankan law recognizes and protects the right to legal representation, both in criminal as well as civil cases.

“Therefore, the Bar Association of Sri Lanka strongly demands that the authorities ensure that Mr. Peiris’s professional duties as an Attorney-at-law, are not hindered and, ensure his safety.”

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