The right surgery – at the right time

Just one month after our surgical-educational mission to Lima, Peru, a Heart to Heart team is on the ground at the Chelyabinsk Federal Cardiac Center (CFCC), located beyond the Ural Mountains of Russia – where the continents of Europe and Asia meet. On this trip, the Heart to Heart team is focused on education and training associated with the diagnosis, treatment, and post-operative care of newborns and infants with critical forms of congenital heart disease (CHD).

Over 1,500 children are born with CHD in the Urals Federal District each year. The CFCC is one of the very few institutions in the area where children can undergo open heart surgery. Nearly all of CHD patients from Chelyabinsk and surrounding regions are referred to the CFCC. To save babies and children with CHD, medical communities must be able to collaboratively diagnose, refer, and provide surgical treatment in a timely manner – according to the severity of heart defect that a child is born with. To achieve this, the CFCC is developing a district-wide network of pediatric cardiologists and pediatricians from different types of local facilities, such as: maternity wards, perinatal centers, general hospitals, and children’s hospitals.

Dozens of doctors have traveled to Chelyabinsk to observe our surgical-educational mission. In addition to attending our team-wide clinical case conferences, each day many ICU specialists crowd into a small room adjacent to the ICU to listen to Dr. Janet Simsic (PCICU Intensivist, Nationwide Children’s Hospital) review our daily surgical cases. The group discusses each patient’s defect, pre- and post-op cardiac anatomy and physiology, details of the surgical repair, and specifics about what will need to be monitored post-operatively by the intensive care team.

The Russian-American operations are led by cardiac surgeon Mark Galantowicz (Nationwide Children’s Hospital) – internationally recognized for his skills in newborn open heart surgery. Our first case was performed on a 5-month-old girl diagnosed with pulmonary atresia (with intact ventricular septum). Her heart cannot pump blood out to her lungs for oxygenation because one of her valves did not develop in utero. She’s previously had one surgical procedure – a Blalock-Taussig shunt – and is now ready for her second staged surgery. On Tuesday morning, July 26, the joint Heart to Heart-Chelyabinsk team performed a bilateral Glenn open heart surgery on her. She is now recovering in the ICU – agitated, but doing well medically. She is almost ready to be discharged to the ward, where she can be with her mother.

Congenital heart defects range in severity. A baby can be born with a mild or severe form of CHD – making timely diagnoses and treatment key to saving children’s lives. On Wednesday, a 6-day-old baby girl underwent an aortic switch operation. The same day we heard about a 3-day-old baby, weighing less than 4 pounds, who will soon be admitted to the CFCC to undergo a more rigorous diagnosis and likely undergo surgery. Earlier this week, pediatric cardiologist Nathan Taggart (Mayo Clinic, Rochester, MN) led the Russian-American team in performing an emergency interventional catheterization on a newborn baby with pulmonary valve stenosis, allowing her to avoid more invasive open heart surgery until she is older and stronger.

To supplement our daily educational programs, over the course of our operating week, we will jointly: conduct open heart surgery on 4-5 children; perform several diagnostic and interventional heart catheterizations; examine dozens of babies and children; and consult on patients from all over Chelyabinsk and the surrounding regions. Over the next several years, Heart to Heart medical volunteers will continue to return to the CFCC annually to transfer more of their knowledge and skills in order to help the Chelyabinsk team reach increasingly higher levels of surgical complexity as they grow their new children’s heart program to reach world-class standards.

Thank you for your continued support of our life-saving work for children in Russia’s heartland!