Multi Track system

Philipp Bonhoeffer teaches at an echo course in Nairobi,1993.

In 1992 Prof. Lucio Parenzan asked Philipp Bonhoeffer to help him develop cardiac services in Kenya. His initial role was to teach diagnostic techniques such as echo.

However treatment options even on a very moderate scale soon became necessary in order to create a positive impact for the patient population. Diagnosis without treatment options obviously was increasing frustration in the patient population in need of cardiac care.

The simplest treatment option for patients with heart disease was the dilatation of pulmonary stenosis. Kenyatta Hospital in Kenya had a very old and rudimentary catheterisation laboratory which could be used for this treatment.

The first cases of pulmonary dilatation in Kenya were successful and had a large impact. They became the symbol for the possibility that cardiac care could be carried out in East Africa and generated major public interest.

This treatment was targeted towards a relatively uncommon disease and the cardiologists headed by Dr. Gerald Yonga and Dr. Christine Jowi pushed towards the treatment of mitral stenosis since this disease has a high prevalence in poor countries and the treatment would have a higher impact and relevance.

The first pulmonary dilatations in 1993 showed that cardiac treatment was possible in Kenya.

Unfortunately at the time the cost of a single use Inoue catheter, usually used for mitral dilatation, was of approximately 5000$. This was clearly unaffordable in the context in which this project was carried out. However Dr. Yonga and Dr. Jowi triggered the interest of Philipp Bonhoeffer to try to develop a more cost effective system for mitral dilatation.

He generated a system which would allow two catheters to run on a single guide-wire . This simple system allowed to reduce the size of the vascular approach and led to an economically attractive alternative to the Inoue system.

In association with Allen Tower at NuMed these catheters were developed and constructed.

In 2004 Philipp Bonhoeffer invited Mr. Allen Tower (president of NuMed), Prof Daniel Sidi and Dr. Jean Francois Piechaud to join him in Kenya in order to evaluate patients for mitral dilatation and to perform the first in man procedures of mitral dilatations with the Multi-track system with the local Kenyan team mainly represented by Dr. Gerald Yonga and Dr. Christine Jowi http://www.ncbi.nlm.nih.gov/pubmed/8829845.

The first interventional catheterization in Kenya.

The first procedures were successful however many modifications of the catheters and the technique needed to be carried out over the next two years.

The mitral Multi-Track system

In association with Allen Tower (president NuMed) Philipp Bonhoeffer tried to develop a non profit company with the intention to make mitral dilatation at cost for this typically extremely poor and needy patient population. After the first idea of a local production of the catheters in Kenya turned out to be impracticable a company was founded (MAP Medical) which was later transferred into NuMed. After obtaining regulatory approval NuMed has distributed the Multi-Track kit for mitral dilatation to many countries around the world.

In Kenya many hundreds of patients have benefitted from the technology and all catheters were provided at no cost by the generous contribution of Mr. Allen Tower.

The MultiTrack angio catheter

The concept of running a catheter next to a guide-wire as used in the Multi-Track mitral dilatation system later also found an important application in diagnostic cardiac catheterisation. Indeed the MultiTrack angio catheter was the first catheter designed by Philipp Bonhoeffer to gain world wide acceptance. It allowed to perform cardiac angiography in the presence of a guide-wire and importantly facilitated and improved the imaging during cardiac intervention.

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