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Cardiac Alliance returns to Ecuador

 

With our trip sponsors With Every Heartbeat, The Fialeny Foundation

Novick Cardiac Alliance worked at Hospital del Nino’s Dr. Francisco Ycaza Bustamante in Guayaquil, Ecuador April 28 – May 12, 2018. This was the first time our team returned to Hospital del Nino since 2014. This trip was made possible by the generous donations from our partners “With Every Heartbeat, the Fialeny Foundation” and support from Ecuadorian charity “Fundacion El Cielo Para Los Ninos.”  Our team consisted of 17 medical volunteers from 12 different centers in the USA and Argentina. 

 

Over the two week trip, NCA Cardiologist Dr Mark Gellat evaluated nearly 70 children, performing echocardiograms and assessing these children for heart defects. Led by NCA pediatric heart surgeon Dr Marcelo Cardarelli, fifteen children received life-saving heart surgery in 8 days of operation. We were pleased to discover that the local team in Guayaquil had been continuing their education and teaching new staff skills to become more competent in pediatric cardiac care and surgery. The local surgeon Dr Hernan Montero has been operating in the absence of visiting teams and the ICU has been led by Venezuelan Intensivist Ricardo Briceno. Each morning during patient rounds, Dr Briceno quizzes nurses and new doctors about a specific defect or complication in order to expand their critical thinking skills.

The ICU team was led by PICU nurse educators Farzana Shah and Roslyn Rivera. Our ICU physicians and nurses provided 24 hour care for these children before and after surgery the entire two weeks. Many of the children were discharged from the hospital within 48 hours of surgery. The majority of the children we operated during this trip were between 5-12 years old, with simple heart defects that require surgery in order for them to survive into adulthood. These children have been on a waiting list for surgery for several years, but there are not enough surgeons in Ecuador to provide surgery. The babies born with more complex heart defects are often not as lucky. Complex heart defects require early intervention for babies to survive to age one. Our trip to Guayaquil helped enhance the medical skills of the surgeons, doctors, and nurses so they can continue to provide treatment for children with heart disease in their country. 

Milan is a baby with a complex heart defect that requires immediate surgery to survive.

For four months, Milan’s mother watched her baby turned dark blue whenever he would cry. Several times, she took him to the doctor in the village where they live, but the doctor would say that Milan would “grow out of it.” Searching for answers, Milan’s family brought him to the pay-clinic in Guayaquil. There the doctors told her he had a serious problem with his heart and he needed to see the cardiologist at the Bustamante Children’s Hospital. As if by fate, the next day, NCA cardiologist Dr Gellat saw Milan. Just from seeing his blue pale appearance, Dr Gellat knew immediately that Milan did indeed have a complex heart defect. The echocardiogram showed that Milan had pulmonary atresia, meaning blood was not flowing the normal way into his lungs to receive oxygen. His blue color was from severe lack of oxygenated blood. Our team discussed a plan and Milan received surgery to create a pathway for blood to flow to his lungs. 

Milan had a difficult recovery after his surgery, but was doing very well when our team left the country. We have received updates from Milan’s parents that is now home and happily growing. His parents were immensely happy to see their baby boy finally looking well.

It’s babies like Milan that remind us how desperately advanced pediatric cardiac care is needed in developing countries. Our teams strive to educate local teams about pediatric cardiology so that babies like Milan can be properly diagnosed and treated early, and given a chance to survive. 

Dr Novick featured in Men’s Journal

Journalist Jordan Campbell joined our team on several trips this past year gathering information about Dr. Novick and the mission of Novick Cardiac Alliance. The article is featured in Men’s Journal June 2018 edition.

 

The World Loses Another Giant in Pediatric Heart Surgery

Dr. Francis Fontan

When receiving the news that Dr. Francis Fontan passed away earlier this week, Dr. Novick’s initial response was “Another giant in pediatric heart surgery passed from our midst.” Dr. Fontan is the individual who pioneered the development of the “Fontan” operation. The Fontan operation made it possible for those children born with one ventricle to have a chance to separate the “red” from the “blue” blood and lead nearly normal lives for many years. Dr Fontan’s contribution to the field of pediatric heart surgery cannot be over-emphasized as it is the final operation which nearly all children born with one ventricle receive thus providing them with a future free of the debilitating effects of chronic cyanosis.

Fontan Procedure

 

Dr. Novick reminisced about meeting Dr. Fontan.

“As a resident in cardio-thoracic surgery at the University of Alabama from 1987-1991 I was fortunate to meet Dr. Fontan on more than one occasion because of his professional and personal relationships with Dr. John W. Kirklin and Albert D. Pacifico. I will never forget my first encounter with Dr. Fontan. He was visiting Birmingham to work on the finishing touches of his sentinel paper with Dr. Kirklin, “The Perfect Fontan”. On the day I had the honor of meeting him I was assigned by Dr. Pacifico to start the second case of the day. As would have it, by design I am sure, it was a child who needed a completion “Fontan.”

As usual this required a redo-sternotomy, which we performed without difficulty. When I sent word to Dr. Pacifico that the sternum was open, I received an unusual response, “Proceed”, which meant he wanted me to lyse the adhesions and place the cannulation sutures to enable the patient to be placed on bypass. I knew that Dr. Fontan was in the hospital and might be visiting the operating rooms, so I was a bit nervous. Nonetheless we proceeded without incident. When I sent word again to Dr. Pacifico that we were ready for him to cannulate and place the patient on bypass, I was again greeted with “Proceed.” This response was totally unexpected as I had never placed a “Fontan” completion patient on bypass, and I was early in my residency. So, as I was placing the arterial cannula, Dr Fontan suddenly appears above the anesthesia screen and says ‘Good morning Dr. Novick!’ Well as fate would have it, I muffed the cannulation and could not get the arterial cannula in. I stopped and responded ‘Good morning Dr. Fontan, sorry I muffed the cannulation, could you please ask Dr. Pacifico to come now.’ Francis laughed and apologized for spooking me at exactly the time I had tried to place the aortic cannula. Remembering this encounter with Dr. Fontan reminds me of the importance of having a sense of humor even while performing challenging heart surgery.”

Francis Fontan, creator of the Fontan operation, actually considered his greatest accomplishment the formation of the European Association of Cardio-thoracic Surgery. He is truly an innovative leader in pediatric cardiac surgery and one of the main individuals responsible for the progress of cardiac surgery in Europe. The world will miss Francis, but we can never forget his tremendous contributions to the field of cardiac surgery, specifically pediatric cardiac surgery. His legacy to this world can be found in the thousands of adults living with Fontan circulation today. We imagine that he and Dr. John Kirklin are together now, perhaps discussing “The Perfect Fontan.”

Novick Cardiac Alliance Featured on ShareAmerica

Cardiac Alliance has been featured on ShareAmerica, a platform produced by the US Department of State. Our story has been shared to all the US Embassies worldwide. This particular story can be translated into seven different languages. Read the article on ShareAmerica to learn more about our life-saving work in war-torn areas.

Witnessing Sustainability in Libya

Two brothers, Four heart defects.

In 2012, we met Abdul, a Libyan boy who was born with four heart defects, called Tetralogy of Fallot. Dr Kathleen Fenton operated on Abdul alongside Libyan pediatric cardiac surgeon Dr Wejdan Abou Amer. Because his heart defects were diagnosed late, Abdul was very sick following his surgery and remained in the ICU for many days. Our team was scheduled to leave the country, but Dr Fenton changed her flight to stay and help the Libyan team care for Abdul. 

Abdul, 2012

In June, our team returned to Benghazi and met Abdul’s little brother Mohammed. Mohammed has also been diagnosed with Tetralogy of Fallot. His parents were devastated to learn their second son also had a life threatening heart defect. It is “life threatening” because he lives in war-torn Libya with limited basic health care available, let alone pediatric heart surgery. 

Mohammed, 2017

Since our team has been visiting Libya and educating the local Libyan medical professionals for several years, we are witnessing the magic our work accomplishes. Mohammed needs a type of surgical procedure that the local Libyan surgeon Dr Wejdan can now perform on her own! Dr Fenton collaborated with the Libyan team and determined that Mohammed’s surgery can be performed by Dr Wejdan after our team leaves the country. From our continued teaching, she has developed the skills to do this, and the ICU team has the skills necessary to care for a patient like Mohammed. 

Dr Wejdan and Dr Fenton operating in Libya.

Without our continued perseverance to travel to Libya, children like Mohammed and his brother Abdul would not survive. There would be no miraculous story to tell. 

And by the way, Abdul is now 6 years old and attending school! 

4 Reasons We Provide Heart Surgeries in a War Zone

4 Reasons We Provide Heart Surgeries in a War Zone

Libya is a country in turmoil, with a health care infrastructure that is falling apart. We get criticized sometimes for continuing to go to Libya to perform lifesaving heart surgeries in the midst of the violence and chaos.

‘They need aid’ is what we hear in America, when the topic of Libya comes up.

Here are four reasons why we provide heart surgery in a war zone like Libya:

  1. Libyans know what they need—and they asked us to come.

Libyans are savvy. They care for their own people. They want to provide what their people need. It isn’t helpful to come from the outside, without intimately knowing the situation on the ground, and assuming to know better.

  1. By teaching best ICU care practices, preservation of sterilization in the operating room, and echocardiogram diagnosis techniques—as well as surgical techniques—we raise the level of care across the board.

Local medical staff who master best practices in care of young heart surgery patients are able to apply those skills in every other hospital department.

  1. When we teach the skills required to perform pediatric heart surgeries, local medical staff can then handle whatever gets thrown at them.

When doctors and nurses become skilled healing the smallest, most vulnerable patients, with incredibly challenging heart defects, they have the skills needed to handle trauma, and any other condition they might be presented with.

  1. It’s within our hands to do.

We aren’t the UN. We aren’t the World Food Programme. Thankfully, those groups already exist to provide broad relief aid.

We are focussed on the immediate needs of Libyan children who need heart surgeries to live, as well as a medical system which requires more trained medical personnel to care for their own citizens.

We are focussed on what is needed right now. But at the same time, we are able to help bring positive systemic change. We all have the ability to contribute to the stabilization of Libya—this is how we do it.

For Libyans, Is a Tiny Boat In A Huge Ocean the Only Way To Get Care?

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“Unable to get specialist care for his six year-old daughter in Libya or a visa for treatment

abroad, Abdulhakim Shaybi bought a motor boat and set off with her last month across the Mediterranean. Two and a half hours into their journey from Sabratha in western Libya, they reached a European ship deployed to rescue migrants.

‘I raised a white flag to the ship in a sign of peace,’ Shaybi told Reuters by phone this

week from the Italian city of Genoa, where his daughter Sajida, who has the rare blood cell disease aplastic anemia, is now undergoing tests. ‘My friend told them that we have a sick little girl.’

‘We are only conducting emergency operations now,’ General Manager Mukhtar al Habbas told Reuters [from Tripoli]. ‘We have no anesthetic, sterilizing materials, or medical gauze, so how we can work?’

It is a similar tale across Libya. About half of the country’s 159 hospitals are either closed or barely delivering services, said Haroon Rashid, a World Health Organization official.”

The current health care situation in Libya is so precarious that the father of a sick young girl risked an ocean crossing to get her the treatment she desperately needs. Nearly 3,000 refugees died this year alone, making this same crossing.

This is why we continue to work in Libya. This is why we partner with Libyan surgeons, cardiologists, and nurses—so desperate fathers don’t have to make these kinds of choices.

How do we celebrate World Down’s Syndrome Day?

How do we celebrate World Down’s Syndrome Day?

Today (March 21st) has been dedicated as World Down’s Syndrome day by the United Nations. Nearly half of all children born with Down’s Syndrome will have a heart defect as well. The Novick Cardiac Alliance is committed to bringing sustainable health care solutions to all children with cardiac disease in the developing world.Alex being silly on ward copy

 

“Persons with disabilities, including those with Down syndrome, are more than persons in need of assistance; they are agents of change who can drive progress across society – and their voices must be heard as we strive to reach the Sustainable Development Goals.”
Ban Ki-moon Secretary-General of the United Nations

2015.02.09.Tobruk.Libya.Fuji._71 (1)Cardiac Alliance operate on children with Down’s Syndrome in 11 countries around the world this is about 12% of all the children that we operate on every year. This is not enough! We need to reach more children and we need your help to do it. Children with Down’s Syndrome are more than a collection of symptoms or a disease and like the rest of the population they learn at school, have interests, hobbies, talents, friends and relationships. Down’s Syndrome occurs in all races, religions and economic situations but when a child with Down’s Syndrome cannot get the Cardiac care they need their world becomes smaller and restricted- they cannot play or go to school or make friends – they are also much more likely to die in childhood. We are celebrating Down’s Syndrome day by renewing our commitment to meeting the needs of this unique and valuable group of children. Join us in our celebration  Donate financially today or volunteer with us and help us reach more children like these!.

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Artem

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Lamar after surgery 2

Sajad and grandmother