STS News, Summer 2022 — From research funding to traveling fellowships to specialized training that can help surgeons introduce state-of-the-art programs worldwide, The Thoracic Surgery Foundation (TSF) offers career-changing opportunities for surgeons at every experience level. Support from TSF can fuel projects like Salvando Corazones (“Saving Hearts”), led by Aldo Rafael, MD, a recipient of the TSF Every Heartbeat Matters award. On their latest mission trip this spring, Dr. Rafael’s team was able to save the lives of 11 patients from underserved regions of Peru. These patients had rheumatic and degenerative cardiac conditions such as rheumatic valvulopathies, aortic aneurysms, and severe coronary artery disease. The team focused on minimally invasive valve replacement, working alongside local surgeons, anesthesiologists, perfusionists and nurses at Dos de Mayo hospital in Lima—and giving them hands-on training in new techniques. “We had the pleasure of showcasing this novel approach to the cardiac surgery department at the hospital,” wrote Dr. Rafael in his TSF report. “There was a collaborative effort with the education and hands-on teaching involved with each surgical case.” All of the patients did well postoperatively, with no significant surgical complications, the team reported. Dr. Rafael has a special place in his own heart for Dos de Mayo because it served as his training ground—he was the first graduate from the institution’s cardiovascular surgery program. Born and raised in Jauja-Junin, Peru, about 6 hours outside Lima, he says he now has the privilege of giving back to his Peruvian community. “Salvando Corazones has allowed me to form a close friendship—a brotherhood—with many healthcare professionals, including doctors, nurses, technicians, and administrative staff,” Dr. Rafael said. The March 2022 Salvando Corazones mission saved the lives of 11 patients who otherwise had no recourse to correct their heart defects. Minimally Invasive Techniques Help Combat Ripple Effects of Rheumatic Fever As a surgeon at Baylor University Medical Center in Dallas, Texas, Dr. Rafael has access to new procedural techniques that under-resourced countries don’t, he stated. “Minimally invasive valve replacement surgery for rheumatic heart disease is the current standard of care. Salvando Corazones focuses on training the local Peruvian medical staff while providing free-of-charge cardiac surgeries to an underserved population.” In 2013, Dr. Rafael’s team introduced Peru’s first minimally invasive valve surgery via mini-sternotomy and utilized new techniques to protect the brain during cardiopulmonary bypass. Then, in 2015, Dr. Rafael performed the first minimally invasive aortic and mitral valve replacements in Peru that were accessed via right mini-thoracotomy. “The March 2022 trip allowed me to introduce a left atrial appendage exclusion device to the surgeons at Dos de Mayo Hospital,” he said. These surgeries helped to ensure improved quality of life for the patients by providing a long-term solution in a region where rheumatic cardiopathy remains an ongoing concern. In low- and middle-income countries, rheumatic fever complicated by rheumatic heart disease still contributes to morbidity and premature death—accounting for up to a quarter of a million deaths every year, Dr. Rafael said. “In our patients at Dos de Mayo Hospital, we found high frequency of rheumatic valve disease—most of them in young patients. These patients usually contract rheumatic fever in childhood or adolescence and develop symptoms between 20 and 40 years of age.” In under-resourced countries, up to 3% of school-aged children have evidence of rheumatic heart disease detected by echocardiography. Dr. Rafael identifies this as a public health problem, one that, thanks to the generosity of donors to TSF and other entities, can be addressed in a concrete way, and can certainly make all the difference for individual patients. Amidst Pandemic, Mission Sent Lifesaving Equipment from Afar In 2020 and 2021, the COVID-19 pandemic prevented the Salvando Corazones team from traveling to Peru. However, they were able to ship two donated heart-lung machines to the hospital. “These costly machines are a limiting factor for regional hospitals in Peru to start cardiac surgery programs,” Dr. Rafael explained. “This has led to a 1,000-person waitlist at Dos de Mayo Hospital, the national referral center for cardiac surgery for 65% of the population on government insurance.” This insurance only partially covers the cost of the surgery and does so for only a limited number of patients per year, he said. Dr. Rafael’s staff teamed up with Peruvian surgeons, perfusionists, nurses, technicians, and administrative support personnel—leaving them with the tools and skills to continue the work. The team also was able to partner with several companies for supply donations, including valves, sutures, lap sponges, cannulas, hemoconcentrators, and more, said Dr. Rafael. Supplies that remain after the Salvando Corazones team’s departure will be used year-round by the Peruvian staff to continue saving lives. Salvando Corazones will celebrate its 10th anniversary this year, and to mark the occasion, Dr. Rafael will host a minimally invasive cardiac surgery symposium at Dos de Mayo, imparting new techniques to more Peruvian surgical teams as part of a cross-continental faculty. “Together, we have delivered—and will continue to deliver—superior patient care, and we have served a role in advancing minimally invasive surgery and therapies for advanced heart failure among the cardiothoracic surgery residency program at Dos de Mayo Hospital,” Dr. Rafael said. “On behalf of all those involved, we are grateful for your generosity, your trust, and—most importantly—your commitment to our medical mission.” Every Heartbeat Matters Is One Among Many TSF Opportunities The TSF Every Heartbeat Matters Award, is only one of a wide array of grant and scholarship opportunities offered by the Society's charitable arm. Applications are open for TSF awards, and the deadline to apply for most is September 15. Learn more at thoracicsurgeryfoundation.org. Annual Report Highlights Results of Awardee Innovation, Donor Generosity Illustrating the stories behind the Foundation’s scholars, investigators, volunteers, and donors, the 2021 TSF Annual Report now is available. The report features breakdowns of award disbursements, testimonials from grant recipients, photos from clinical projects and mission trips, and a listing of major gift donors. In 2021 alone, TSF dispersed more than $1 million in funding for cardiothoracic surgery research, education, and outreach. All TSF administrative costs are absorbed by the Society and corporate grants, meaning that 100% of donations is directed toward award funding. Visit sts.org to read the report.
Jul 7, 2022
5 min read
STS News, Summer 2022 — While the fighting in Ukraine rages on, global congenital heart surgeon William M. Novick, MD, can be found in the operating rooms of hospitals throughout the war-torn country, saving lives of the littlest patients. These operations are considered challenging; they are complex, dynamic, and often time- and resource-constrained. Not to mention the additional risks that result from the fighting and life-threatening danger on the other side of the hospital walls. “When I hold a child’s heart in my hands, I experience an extremely scary, humbling, and challenging series of thoughts,” said Dr. Novick. “Scary, because that child might die. Humbling, in that God gave me the ability to do this. Challenging, because we want to save every child no matter how bad the defect is.” Dr. Novick, from the University of Tennessee Health Science Center in Memphis, and his team from the Novick Cardiac Alliance have traveled to Ukraine several times over the years, and they’ve committed to four visits in 2022. So far, they have completed three—traveling to the country in January, March, and, most recently, in June. “The physical damage being caused in the country is going to set back medical care in Ukraine years, maybe decades,” he said. “We were in the country during the last week of January and the first week of February. While our team was there, there was a developing threat of a Russian invasion, with troops already staging on the border and in Belarus.” Dr. William Novick champions the expansion of pediatric cardiothoracic surgery in under-resourced countries, both operating on children and training others to do so. Then, while the team was in Lviv this spring, the far western Ukraine city was bombed, said Dr. Novick. Even so, they worked day and night, desperately trying to complete as many surgeries as they could in a short amount of time. “They put us up in the hospital,” he said. “There’s no room anywhere in the city, in any hotel, because of all the refugees. We took a nap, I talked to the administrator, and then we got started.” Dr. Novick and his team operated on six children: three newborns, and another three who were just days old. Each year, 1 million children in low- and middle-income countries are born with congenital heart disease, according to Dr. Novick, and most do not have adequate pediatric cardiac care. The most challenging place in which he’s operated was Tashkent, Uzbekistan. The conditions included ancient equipment, unclean operating rooms, and dangerous power supplies. “There was a bypass machine—unplugged—on a counter,” said Dr. Novick. “Sitting on the floor next to the machine was a pair of heavy rubber gloves and rubber boots. Our perfusionist went to plug in the bypass machine. Simultaneously, six Uzbeks screamed, ‘NYET! Put on gloves! Put on boots!’ So he did, and when he plugged in the machine, sparks flew.” Dr. Novick explained that many of these countries don’t have any options for heart surgery unless it’s charitable. “And, what makes this work special is we are doing it in places where no one else wants to go,” he said. So Much More than Surgery In addition to their surgical skills and expertise, Dr. Novick and his team in March brought to Ukraine 14 massive bags of supplies to support pediatric heart surgery and pediatric cardiology, and for the trip in June, he shipped 12 pallets of equipment and materials. This is important to note because the Cardiac Alliance works to save lives, but also helps local teams assemble and sustain cardiac centers. In fact, the centers that the Cardiac Alliance builds typically are sustainable within 3 years. “We do pediatric heart surgery, but we also train pediatric cardiologists, and nurses in the ICU, respiratory therapists, those who run the heart-lung machine, and the catheterization lab technicians. We try to get all these people trained up to improve their diagnostic skills, or work on catheterization or anesthesia, and we do a lot of it in conflict zones,” said Dr. Novick. Dr. Novick and the Cardiac Alliance team visited Lviv, Ukraine in June 2022. ‘You Protect People…That’s Your Job’ Dr. Novick is not only doing much of the surgery himself, but he’s also gathering donated supplies, lining up financial contributions, and organizing training programs. Described as the undisputed leader of the Novick Cardiac Alliance, he’s known to run the team with a “thundering hand.” And his work in these countries—especially in Eastern Europe—holds personal significance for Dr. Novick. His grandmother, who is Ukrainian, and his grandfather, who is Russian, escaped Soviet Russia many years ago to settle in the US. With these roots, Dr. Novick credits his father for his “Russian temperament, tenacity, and persistence.” From his mother, he learned “all the soft things” such as his concern for children regardless of where they are in the world and his deep desire to repair children’s hearts. Just as importantly, his parents taught him, “You never, ever intimidate anybody. You protect people that are intimidated or bullied by other people. That’s your job. You’re big enough to do it.’ So that’s the way I was brought up: help those who are not able to help themselves,” Dr. Novick said. Over the years, he has done just that—made saving and protecting lives his life’s work, helping more than 10,000 children in 30+ countries, including places like Libya, Iraq, the Democratic Republic of the Congo, Russia, and China. “I’m very passionate about this work,” Dr. Novick said. “Unless you go to these places, I don’t think you can really grasp how desperate the situation is for these kids and their parents. Our team showing up, and their kid getting operated on—they truly consider it a miracle. I’m very humble about what we do, but you’re in a country of 85 million people and there’s no heart surgery for kids, and your child is one of 18 who gets operated on? I mean, holy moly.” For more information about the Novick Cardiac Alliance, visit cardiac-alliance.org.
Jul 5, 2022
5 min read

The Congenital Heart Surgery Database (CHSD) continues to undergo improvements to enhance quality of care for patients. In this webinar for CHSD participants, the panel discusses the forthcoming upgrade to version 6.22 and implementation of new STAT scores. The webinar also includes a review of the brand-new Adults with Congenital Heart Disease (ACHD) component. The surgeon leaders discuss the goals for the ACHD component, how data will be captured, and what the future holds in terms of risk assessment for this rapidly growing population.

Date
Duration
34 min.

Study shows multidisciplinary pediatric care improves patient outcomes and experiences 

**A recorded press briefing featuring this research is available.**

Jan 27, 2021

The Thoracic Surgery Foundation offered its first International Medical Volunteer Scholarship to cardiothoracic surgery resident Kellianne Kleeman, MD, from the University of Michigan, so that she could participate in a charitable medical mission to an underserved region of the world. Dr. Kleeman recently traveled to Nepal, with Fred Grover, MD, and his team on their annual trip to help people in South Asia.