Blog : Congenital Heart Disease

Lessons Learned in Humanitarian Cardiac Surgery

Novick Cardiac Alliance had the opportunity to attend the 32nd Annual Meeting of the European Association for Cardio-Thoracic Surgery (EACTS) in Milan Italy in October 2018. Watch the video below of Dr. William Novick and Dr. Marcelo Cardarelli as they discuss “Lessons Learned in Humanitarian Cardiac Surgery.”

 

Humanitarian Footprint

Novick Cardiac Alliance has published a research article in JAMA, a peer-reviewed medical journal published by the American Medical Association. The article is titled “Cost-effectiveness of Humanitarian Pediatric Cardiac Surgery Programs in Low- and Middle-Income Countries”. It describes the cost-effectiveness of providing heart surgery to children in developing countries, but it also accounts for the long-term effects at the individual and societal level.

“The Humanitarian Footprint”, as we describe this the long-term effect, is measured in extra years of life expectancy, extra years of schooling and lifetime income potentially added for the patients treated in our global humanitarian interventions.

It turns out that in 2015 alone, there were 16 932 years of Life Expectancy, 1 484 years of schooling and $67 642 191 lifetime income potentially added to the cohort of patients we operated around the world. We always suspected humanitarian pediatric cardiac surgery was doing something good for our patients and the world. Now we have the data!

Read the full article: Humanitarian Footprint

 

DR NOVICK FEATURED ON RMWorldTravel RADIO SHOW

Dr Novick recently was interviewed by RMWorld Travel, America’s #1 Travel Radio Show. RMWorld Travel reaches well over 1 million upscale leisure and business travelers via 375+ affiliated weekly radio stations across the USA, as well as our global 24/7 TuneIn.com channel, live streaming, social media, online and more. 

RMWorld Travel says “Since Travel can be more than a  beach vacation or catching a flight to make a business meeting in another city, we invited Dr. Bill Novick to join us during our live broadcast of RMWorldTravel with Robert & Mary Carey and Rudy Maxa, for our “Personal Connection” series on 30 June 2018, to share some of his experiences via his travels to provide meaningful impact on kids, families and communities globally, as well as the opportunities for others to do the same.”

Listen to his interview HERE 

You can follow RMWorld Travel on their Facebook page.

 

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.

 

Over 1,000 Hearts Healed in Iraq

 

Dr. Novick with Ayad in Nasiriyah Heart Center

In August 2010, before the end of the Iraq War, Dr. Novick and his teams began traveling to Iraq. We believed that Dr. Novick’s vision to provide cardiac care and surgery to children suffering from heart disease was more important than politics, religion or where these children were born. Over the course of the past 8 years, we have worked in 6 hospitals located in 5 different cities throughout Iraq. In December 2017, we celebrated performing our 1,000th pediatric heart surgery in Iraq.

 

Mohammed – Our 1,000th child operated in Iraq

Mohammed was only 17 days old when he received his life-saving heart surgery from our team in Karbala, Iraq. He was born with Transposition of the Great Arteries and without surgery, the chances of him surviving to be one year of age was slim. Weighing just 3 kilograms, Mohammed’s heart was only the size of a strawberry. Cardiac Alliance surgeon, Dr Marcello Cardarelli and Iraqi surgeon Dr Ahmed Ebra worked together to perform this delicate surgery. Mohammed recovered over the course of two weeks in the ICU and is now home with his parents just outside of Karbala. Mohammed may be the 1,000 child, but there are still thousands more children waiting for heart surgery in Iraq.

 

Since 2010, we have expanded our programs across the country of Iraq, beginning in the north in Sulaymaniyah to the spiritual capitol of Najaf. In the south, we began pediatric cardiac programs in Basra and at two centers in Nasiriyah. Our program in Karbala, located in central Iraq, has flourished with a fast-learning Iraqi pediatric cardiac surgeon. It’s through our collaboration with these 5 centers in Iraq that we have been able to provide life-saving heart surgery for over 1,000 children in Iraq.

Novick Cardiac Alliance is the only organization providing pediatric heart surgeries in Iraq. We strive to fulfill the ever-growing list of children who require surgery to survive. Without our volunteers and supporters, we could not achieve this. Thank you for you continued support.

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.”

From West Africa to Lebanon – In Search of a Fix for a Broken Heart

There are thousands of children with undiagnosed heart defects waiting for someone to find them to save their lives. On our inaugural trip to Lebanon, Cardiac Alliance met a child who traveled from West Africa to southern Lebanon in search of a definite diagnosis and hopefully life-saving surgery. How was is that four-year-old Emmanuel, or E-man as his village calls him, who was so sick that he would sleep most of the day, could possibly travel across the entire continent of Africa?! This is a story of perseverance that emphasizes each person’s ability to help a child in need, even when the task seems dauntingly impossible.

Emmanuel was born in July 2013 in the small village of Garplay, Liberia. His mother Kuku describes his inability to eat as an infant, needing to take breaks to breathe rapidly and he didn’t walk until age two. His family was finally able to travel to Monrovia, the capitol of Liberia to find a specialist. Emmanuel was presumed to have hole in his heart, though there is no an echocardiogram machine anywhere in the country to actually check his heart. His symptoms of extreme difficulty breathing, keeping his oxygen levels high enough, and playing with his 4 siblings were tell-tale signs. He would often pass out for hours at a time while his family would gather around and pray over him until he came to.

E-man and Kuku in Liberia

Liberia was ravaged for 14 years during a civil war from 1989-2003. Because of this war, the country was left with no electricity or running water and very little medical care. While the country is now growing and improving slowly, the medical system is still very primitive in many areas. When it came to E-man, there were no services available to help him, the only way for him to get healing was to go out of Liberia. But that would cost money and with the majority of Liberians being subsistence farmers, including E-man’s parents, Emmanuel and Kuku, saving the money to get heart surgery in another country would be impossible. So they waited and prayed. For four years, E-man miraculously kept fighting; every time he saw a plane overhead, he would say, “My plane is coming to get me!”

Emily and Brian with children from E-man’s village in Liberia

This is where Emily and Brian from Florida, USA enter the picture. Emily and Brian work on the child sponsorship team for Light Evangelism Ministry and traveled to Liberia in March 2017. Emily describes meeting E-man for the first time, as “..heartbreaking. He was laying on a bench, gasping for air, and whimpering. His lips were blue. He didn’t even have the energy to sit up.” Emily and her organization committed right then and there to exhaust all efforts to get surgery for E-man.

They made dozens of phone calls, just stabbing in the dark, trying to find a hospital in America that would work pro bono to save this child. After months of trying, they finally found a hospital in Florida willing to do the surgery, but were quickly devastated when the American Embassy in Liberia told us they would not grant a medical visa for any reason.

Back to square one. After putting out a general plea on Facebook, one of Emily’s friends connected her with Elizabeth Novick, a founder of Novick Cardiac Alliance and wife of Dr. Bill Novick. Dr Novick accepted to repair E-man’s heart, as long as they could get him to any of the locations where Novick Cardiac Alliance was working. The first available country was Libya, but within days of travel, the visa fell through. Ukraine was next. But their hopes were quickly dashed as they found out E-man and Kuku would have to fly to Senegal to get a visa for Ukraine. The extra travel would be impossible for E-man in his condition and the money for the extra flights was more than anyone could afford.

After some research, Emily discovered that Lebanon had an embassy in Monrovia, Liberia’s capital city! Now, just three weeks before Cardiac Alliance was scheduled to be in Lebanon, Emily and her organization were pressed for time to raise the money to fly E-man across the continent.

On October 11, Kuku called Emily. E-man had had a horrible couple of days. He wasn’t eating. He was sleeping a lot and was not able to get off the floor. He was so very sick. Again Emily took to Facebook and posted a video explaining the call she’d just received. The money started to pour in, and in just one day, raised more than the amount they needed! They were fully funded, and E-man would have his surgery!

One more hurdle. The Visas. Emmanuel and Kuku went to the Embassy and were told the man who wrote the letter from the Lebanese hospital would have to call the Embassy to confirm the validity of the case. From America, Emily called Rashaya Governmental Hospital and was connected with the hospital medical director Dr. Yasser Ammar. Dr. Ammar called the Embassy, and E-man and Kuku were immediately granted their visas… just 5 minutes before the Embassy was closing for the day!

No more hurdles. No more mountains. E-man’s surgery was on its way.

Emmanuel arrived at Rashaya Governmental Hospital in southern Lebanon on October 23, and our team performed an echocardiogram and officially diagnosed E-man with tetralogy of fallot. This diagnosis explained why E-man would often squat when playing with his siblings, his body’s attempt to get more oxygen. His surgery was scheduled immediately.

On October 25, Emmanuel received his healing surgery and we know he has a beautiful future ahead of him. It is people as determined as Emily that can help us save these children. This story brings us encouragement that individual people in the world have the power to bring awareness and treatment for the number one birth defect, congenital heart defects.

We all have hopes that E-man will provide great change in his home country of Liberia one day!

Perfusion Without Borders Scholarship Winner

Each year, the American Society of Extracorporeal Technology offers a scholarship to one Perfusion student to travel on a medical mission trip with an organization of their choice. This year’s winner is perfusion student Kim Morris and she will be traveling with Novick Cardiac Alliance to Ukraine early next year.

Kim Morris, Perfusion Student, USA

Kim moved across the United States from Alaska to New York to pursue education in perfusion. From her experience, she has learned that “a successful perfusionist is reliant on gaining the trust of a room full of people that may come from completely different backgrounds. You treat your patient with your equipment and knowledge, but you also treat the surgeon and a room full of professionals with careful communication and a calm demeanor to ease a stressful situation.”

Several years ago, Kim was a medical volunteer in Ghana and from that experience realized she aspired to gain more personal knowledge to more directly help people in need on her next volunteer trip. Becoming a perfusionist was her answer. She now is feeling more qualified to utilize her skills to directly assist those in developing countries. Kim is excited to join Novick Cardiac Alliance as a perfusion student, honestly stating, “I’ve learned to participate in a highly skilled team to give a patient a permanent, life changing surgery.”

Kim volunteering in Ghana.

We look forward to having Kim join our team as a perfusion student in Ukraine!