The Tomsk Cardiology Institute, Siberian Federal District
The City of Tomsk, founded in 1604, is a major metropolitan center and the site of Heart to Heart’s third children’s heart program. The Siberian Federal District comprises almost 2 million square miles, about half the size of the entire U.S. It is home to 20 million people, roughly three times the population of New York City.
Saving Children in the Vast Siberian District
In 2010, the fifth year of our seven-year collaboration, specialists in Tomsk saved the lives of 374 children through the miracle of open heart surgery and modern interventional procedures. This is our Tomsk colleague's’ highest annual patient volume to date, surpassing Heart to Heart’s initial program targets.
Improving access to modern heart care in Russia today
Tens of thousands of parents still wait and hope for the open heart surgery procedure that will save the life of their child. Once a Heart to Heart sponsored site “graduates” to self-sustainability, the local team will continue to save more than 300 children each year with no further investment on our part. Our Tomsk site will achieve self-sustainability in 2012!
Teamwork: A hallmark of Heart to Heart’s teaching
Dr. Viktor Varvarenko (shown at left above), pediatric interventional cardiologist, has worked closely with Heart to Heart since the collaboration began in 2006. This year he commented, “Sometimes when people come here, they are amazed at how cooperatively we work. They’ve never even dreamed such teamwork could be possible.”
Patient exams and surgical schedule
After months of preparation in the U.S. and long days of on-the-ground patient exams and case conferences, the joint Heart to Heart-Tomsk team finalizes our list of surgical candidates. All aspects of patient care – from diagnosing, to conducting open heart surgery, to managing patient care post-operatively – are discussed and performed jointly.
Heart to Heart-Tomsk team leader Dr. Frank Cetta
Dr. Frank Cetta has been instrumental in guiding the Tomsk team toward self-sustainability. He has led all six annual Heart to Heart surgical-educational missions to Tomsk and hosted several colleagues from Tomsk at his home institution, the Mayo Clinic. Dr. Cetta has followed and advised on the case of Matvey K. (shown here) since Matvey was just a few weeks old.
Communicating in English and Russian
Administrative leaders and chief medical interpreters Irma Ozashvili (left) and Josie Everett work together to ensure that all subspecialists – echosonographers, interventionalists, surgeons, anesthesiologists, perfusionists, intensivists, and nurses – have interpreters with them at all times. Trained interpreters are vital to accurately communicate complex and nuanced concepts.
The “network effect” in action in Russia
This year, 35 visiting pediatric cardiac specialists from five of Russia’s eight Federal Districts joined their Tomsk colleagues to participate in daily conferences and lectures. Many of them travelled great distances (up to 2,000 miles!) to observe the Heart to Heart-Tomsk team’s advanced collaboration.
Perfusion expert and educator Mindy Blackwell
Mindy Blackwell, the only newcomer on this year’s team, gave a well-received lecture on Extracorporeal Membranous Oxygenation (ECMO). She has taught pediatric cardiac perfusion for more than ten years and frequently travels throughout the U.S. as a clinical specialist, training physicians to implant the Berlin Heart device for children in heart failure.
Dr. Bert Litwin: Sharing years of experience
Pediatric cardiac surgeon Dr. Bert Litwin established and then directed for many years the renowned Herma Heart Center at Children’s Hospital of Wisconsin. He has led surgical teams in saving the lives of close to 8,000 children though the miracle of open heart surgery. What an extraordinary opportunity for young Russian surgeons to benefit from Dr. Litwin’s expertise!
Chief pediatric cardiac surgeon Dr. Evgeniy Krivoschekov
Since 2004, Dr. Evgeniy Krivoschekov has experienced seven of our teams in action in Samara and Tomsk. He has also observed U.S. best practices at the home institutions of several of his Heart to Heart colleagues. Dr. K has cultivated strong leaders on the Tomsk team, and he actively promotes education and training for specialists across Russia.
From the pediatric cardiac operating theater in Tomsk
Open heart surgeries were streamed live into a nearby conference room so all specialists could see and hear each advanced procedure in real time. Eleven pediatric cardiac surgeons from across Russia had the invaluable opportunity of watching Dr. Bert Litwin perform open heart surgery.
Beginning stages of a pediatric open heart surgery
Open heart surgery requires at least 7 pediatric cardiac specialists: a cardiologist, a lead surgeon with 1 or 2 surgeons assisting, an anesthesiologist, a perfusionist, an OR technician, and a circulating nurse. On a Heart to Heart mission, the number of specialists in the OR increases to 11 or 12 – as each key position is co-managed by a Heart to Heart specialist and his Russian counterpart.
Teamwork in the operating room
Cardiologist Dr. Frank Cetta (left) performs a transesophageal echocardiogram to confirm the adequacy of the surgical repair before the team proceeds to close the patient’s chest. Each specialist’s expertise adds to the team’s ability to assess any situation and determine the best course of action at any given moment – often in circumstances requiring split-second decision-making.
In the PCICU
To care for patients as complex and fragile as our “heart babies,” expertise in post-operative management is critically important. Here, Dr. Janet Simsic (second from left), Heart to Heart’s lead pediatric cardiac intensivist, updates cardiologist Dr. Frank Cetta on a post-op patient.
Lynn Graham RN leads clinical nursing
Lynn Graham RN has focused on teaching best practices in pediatric cardiac nursing to the Tomsk nurses in the pediatric ward. Working in concert with Heart to Heart’s PCICU team, she has provided advanced education that has significantly elevated the knowledge base of the Tomsk clinical nursing team.
Lisa Poppell RN: Night shift in a Siberian PCICU
Lisa Poppell RN is an intrepid veteran of seven Heart to Heart surgical-educational missions. Every evening, Lisa arrives at the hospital at 7 pm, to be fully debriefed on each child in the PCICU. The rest of the Heart to Heart team then leaves the hospital, and Lisa assumes responsibility for providing intensive care nursing for the next 12 hours.
Brenda Jarvis RN: Advancing nursing in Tomsk
For the last six years, senior PCICU nurse Brenda Jarvis (with stethoscope) has helped provide education for the Russian nursing staff on the anatomy and physiology of congenital heart defects and on post-operative management. At the end of 2011, Heart to Heart will honor Brenda for her dedicated participation on 10 surgical-educational missions across Russia.
Meeting the children
Rose Glickman PhD is an integral part of Heart to Heart. Her live interviews with patients and their parents – conducted in Russian – give voice to the plight of children born with treatable heart disease in a country with extremely limited access to the miracle of modern heart care. At the end of 2011, we will honor Rose for her bilingual reporting of 10 surgical-educational missions.
We love our leaders!
Cardiac surgeons Drs. Vladimir Shipulin and Bert Litwin have earned the respect and affection of every member of the joint Heart to Heart-Tomsk pediatric cardiac team. These inspiring mentors have demonstrated strong leadership while providing brilliant education to dozens of tomorrow’s leaders in this demanding, complex vocation.
Pediatric intensive care leaders
Working side-by-side to provide 24/7 care for very sick children has led to many collegial friendships among Heart to Heartniks. Here, Dr. Janet Simsic and PCICU chief Dr. Alexander Nikolishin celebrate the success of this year’s mission. At the end of 2011, we will honor Janet for her leadership in the PCICU on 10 Heart to Heart missions.
Heart to Heart’s 2011 Tomsk team
(Rear, from left) Bert Litwin MD; Brenda Jarvis RN; Mindy Blackwell; Kim Crews; Lynn Graham RN; Frank Cetta MD. (Front, from left) Lisa Poppell RN; Lena Traer; Rose Glickman PhD; Janet Simsic MD; Josie Everett. Not shown: Photographer Joye Leventhal, who took the photo! Collectively, these Heart to Heartniks have been on 88 surgical-educational missions.
Why we exist
These four precious children were born with life-threatening but treatable heart defects. Heart to Heart’s mission is to develop self-sustaining children’s heart centers that give millions of families access – for the first time – to the miracle of modern heart care. As we carry out our mission, more than 12,000 babies and children have already been saved by Russian doctors we have trained.