“’In Libya, there are several thousand children that need heart surgery, including hundreds of new-borns’, says Dr. Novick. That is why, with the support of the Presidency Council and the UN’s World Health Organization, Dr. Novick has launched a one-year national program, hoping to treat more than 400 Libyan children’s hearts.”
Read more in this article featuring Cardiac Alliance’s work in Libya, by United Nations journalist Abel Kavanagh.
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.
Novick Cardiac Alliance completed a one month trip in Tobruk, Libya March 25 through April 22 2018. This entire trip was sponsored by the World Health Organization (WHO). Over 30 children in Libya received life-saving heart surgery from our team and we helped educate the local Libyan surgeons, doctors and nurses. Cardiac Alliance would especially like to thank Dr Jaffar Hussain, Head of Mission and Country Representative for WHO for his tireless efforts to organize our trip.
Please take a moment and watch this special video recognizing our efforts in Libya with the support of WHO.
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.
PICU nurse Erin Serrano recently joined our team on her first medical mission trip to Ukraine. Erin shares her unique story about why she began her career as a pediatric cardiac nurse and how volunteering with Novick Cardiac Alliance was a dream her entire life.
My journey to pursue a career in the Pediatric Cardiac Intensive Care Unit began the day I was born. Just a few days after birth, I was diagnosed with a congenital heart defect and underwent multiple cardiac surgeries and procedures to save my life. Volunteering with Novick Cardiac Alliance to help patients and families with similar stories as my own wasn’t a choice, it was something I knew I had to do. It was my destiny.
Coming to Ukraine and stepping into a healthcare system that I knew nothing about was one of the most challenging things I have ever done. After just a few days, I realized that leaving my comfort zone was more than worth it. From the first day that we arrived at the hospital, I learned just how resourceful the staff members had to be, considering their limited medical supplies, equipment, and medications. Imagine being a parent of a child requiring cardiac surgery and you are responsible for providing part of their medical supplies because the hospital simply cannot obtain enough. I was astounded to see the local nurses using resterilized supplies. These supplies would most certainly be thrown away after one use in the United States. I realize that we take for granted the abundance of simple supplies and they are precious items in developing countries like Ukraine.
Despite the obvious language barrier that exists, Cardiac Alliance has been successful in educating the Ukrainian medical team in everything from basic ICU care to the most complex cardiac surgeries. To be a part of that education process was the most rewarding part of my trip.
One out of every 100 babies is born with a congenital heart defect and CHD’s are the most common cause of infant death among birth defects. If I have helped just one nurse better their practice while caring for these patients, then I know my time spent was worthwhile. I certainly hope I can volunteer with Cardiac Alliance again and again. Thank you NCA for allowing me to be a part of your incredible mission and to the entire Ukrainian team for teaching me more than I could have ever imagined.
When Narges was an infant, her mother noticed she would become blue when eating or crying. She took her to several doctors throughout Iraq, but nobody could give them any answers. Finally a doctor told them that Narges had a heart defect, but nothing could be done in Iraq to help her. They were encouraged to find help outside the country.
At one year of age, Narges’ parents used all their money to take her to India for medical treatment. Here she was finally given a proper diagnosis. She was born with a complex heart defect, single ventricle with mitral atresia. Even in India, Narges was deemed inoperable.
For years, her family watched their beautiful daughter remain blue and ill, which progressively worsened over the years. Narges’ parents took her to several hospitals in Iraq, hoping that someone could help their daughter. Through the strife of war in their country, Narges’ mother never lost hope. She persevered in her search for a heart surgeon that would take her daughter’s case. Finally, she saw an advertisement from Al-Amal Hospital in Nasiriyah Iraq that announced the arrival of an International pediatric cardiac team that was offering heart surgeries.
Dr Novick met Narges in clinic at Al-Amal Hospital in October 2017. At that time, Narges’ blood oxygen levels were only 70%. Her heart was severely enlarged and the improper circulation of blood inside her heart had been causing lung damage for years. Dr Novick prescribed medication to help lessen some of the damage and requested that Narges return to the hospital for evaluation when our team returned the following month.
In November, Narges and her family returned to Al-Amal Hospital to met with our team. Narges’ heart was still severely enlarged and her only option was a palliative surgery that would prevent further lung damage. The hope was that this surgery would improve her quality of life. Dr Humberto Rodriguez performed this surgery and Narges recovered quickly in the ICU. Our team was impressed by her determination, asking to get out of bed the day after her surgery. She wanted to get cleaned up and loved having her hair brushed and braided by nurse Emily. We witnessed the fight inside this young girl, and we understood where she gained her strength from, her mother.
Narges’ mother emotionally described how difficult it was to watch her daughter struggle to breathe, and how she fought to find proper treatment. Both of her parents really understood the severity of their Narges’ heart disease. They were so thankful to our team for offering her this chance to simply have more time in life.
Sometimes, we cannot completely repair a child’s heart, especially those children who have lived for many years with complex defects. This is why we aim to educate cardiologists and pediatricians to diagnose and plan treatment for these children when they are young. For now, Narges will continue to go to school and spend time with her family. This gift of time is what matters most to the families who are barely grasping at hope.
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 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.
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.
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.”
Brooke Tracy, a perfusion student from the US, recently joined our team on a trip to Kharkiv, Ukraine. She describes her experience as a student on her first medical mission trip.
“There are no words to describe how amazing and influential my first mission trip with the Novick Cardiac Alliance was, but I can say with absolute certainty I would recommend it to anyone! Not only was the team amazing and so well versed in healthcare skills, but they also were some of the most empathetic and passionate people I have had the opportunity to work alongside. Not to mention the local Ukrainian team. They all were very excited to learn from NCA in ways to improve their practice, and they were incredibly welcoming and appreciative of all that NCA has done for their hospital system.
As a perfusion student, I didn’t really know what to expect as our field is pretty dependent upon technology and supplies. I had done some research on the Ukrainian healthcare system, but was vastly underprepared when it came to fully understanding the difficulties in which the local team has in acquiring, what in our practice, is simple equipment. But the lack of equipment never stumped the local perfusionist. Alex and Olga were some of the most innovative perfusionists I’d ever met. In order to make the most of each piece of equipment, their circuit design and construction was innovative. Both were incredibly knowledgeable, but it was humbling to see how much they each were looking to learn more and grow in their practice.”
What she gained as a student:
“In the end, the most inspiring thing about this trip for me was to see the passion and moral of the local team. The nurses were so compassionate and went out of their way to comfort their patients. They really did an amazing job, especially those that were medical students working night shift to gain experience! You could tell that this hospital served their local community in more than just physical care, as the empathy was overflowing with every patient. The parents were allowed back in the ICU with their children post-op and it made a world of difference in the recovery of our patients.
After returning from this trip, not only had I gained a ton of knowledge and skills from both the NCA team and the local team, but I also had a better appreciation for all of the resources that we have at our disposal in the US. I have developed some new practices and little tricks that make my perfusion practice more resourceful and limit my medical waste since returning from the mission.
I can not only recommend missions to anyone in the field, but especially to students because I feel that it gives you a advantage to being a resourceful, motivated, and passionate perfusionist, which is exactly what this world needs more of.”
-Brooke Tracy, Perfusion Student, South Carolina, USA