HEALING THE WORLD WITH EACH HEARTBEAT32nd Mission to Santiago, Dominican Republic

Babyheart Medical Mission Trip ReportNovember 8th-22th, 2014

Special Thanks toCHADASHAProVision TrustHaiti Cardiac AllianceFundación Corazones del CibaoHospital Infantil Regional Universitario Dr. Arturo Grullon

Volume 22Issue 32

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ICHF Mission StatementWhat is Congenital Heart Disease (CHD)?32nd Mission to SantiagoBabyheart PatientsMeet Franchesca!Meet Frankely!Kindhearted Medical VolunteersMeet Dr. Rodrigo SotoTraining & EducationHeartfelt Thank You2015 Mission Schedule

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Table of Contents

Many of these children in developing nations will never see their first birthday because of congenital heart disease. Since the resources to treat and cure congenital heart disease are not readily available in these regions, the parents of these children are often powerless to save them.

The mission of the International Children’s Heart Foundation (ICHF) is to bring the skills, technology, and knowledge to cure and care for children with congenital heart disease to developing nations. ICHF does this regardless of country of origin, race, religion or gender. Our goal is to make the need for ICHF obsolete. We work toward this goal through our medical mission trips, where we operate on children and educate local healthcare professionals.

In operation since 1993, ICHF assembles volunteer medical teams from around the world to provide free pediatric cardiac surgeries, training and medical resources to countries without access to them. We implement our collaborative teaching curriculum by operating with and educating local healthcare professionals in their own hospitals. With this training, the local teams gradually acquire the skills to care for their children independently.

So far, ICHF’s medical teams have performed 7,482 operations in 32 countries around the globe. As a 501(c)3 charitable organization, we enlist your support to provide hope and life for children throughout the developing world.

If you share our same passion for saving children with congenital heart disease, we encourage you to join us as a medical volunteer or a donor.

Together, we can continue to save thousands of lives!

Approximately 1 in every 100 children will be born with a heart defect.

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Table of Contents ICHF Mission Statement

What is congenital heart disease (CHD)? CHD is the general, collective term applied to children who are born with a structural defect of the heart.CHD occurs when the heart or the blood vessels connected to it do not grow normally prior to birth. The structural defect may occur in the heart’s valves, walls, main blood vessels, or any combination of these.

The number of new cases annually of CHD is relatively constant in all countries of the world and is approximately 1 in 100 live births.

What causes CHD? The exact cause of CHD is unknown; however, there are factors that often correlate to the creation of these defects. Some defects may be hereditary and transmit from one generation to the next through genes. CHD can also be linked to chromosomal abnormalities, syndromes, maternal illnesses, or even medications taken during pregnancy.

What is the mortality rate for CHD? Overall, congenital anomalies are second only to prematurity and low birth weight as a cause of neonatal mortality (children under 30 days old.) Among congenital anomalies, cardiac defects are the leading cause of neonatal death.

What are the symptoms? CHD may manifest itself in numerous ways. Heart murmurs, difficulty eating, lack of strength, stunted growth and rapid, labored breathing are among the most common. Cyanosis, or blue-tinted skin, is also a symptom of CHD in newborns and indicates a shortage of oxygenated blood circulating throughout the body.

What treatment is available for children with CHD? Some congenital heart defects can be treated effectively with medications, but many children require surgery as a primary form of treatment. In order to properly cure the patient, a doctor must be able to diagnose the disease. Once a diagnosis has been made, treatment of the defect may include open heart surgery. Consequently, treatment of these defects involves a considerable amount of equipment and skill. Many developing countries lack access to the essential tools and knowledge needed to save these children.

Jonas, Richard A. 2014. Comprehensive Surgical Management of Congenital Heart Disease, 2nd ed.

What is Congenital Heart Disease?50% of children born with heart defects will need heart surgery at

sometime in their life.

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Hospital Infantil RegionalUniversitario Dr. Arturo Grullon

Our 32nd Babyheart medical mission trip to Santiago, Dominican Republic was completed on November 22nd, 2014 at the Hospital Infantil Regional Universitario Dr. Arturo Grullon (Children’s Hospital of Santiago), where 15 children with congenital heart defects received lifesaving surgeries.

The Dominican Republic is located in the El Cibao region of the Hispaniola Island. The country has an infant mortality rate of 21.3 deaths per 1000 births, and congenital heart disease is the 4th leading cause of death.

Dr. Juan Ramirez invited the Babyheart medical team to visit the hospital in 2006, and we have since provided 498 heart surgeries to children at no cost to the patients’ families!

The Babyheart team was led by cardiovascular surgeon Dr. Rodrigo Soto and consisted of a cardiologist, a perfusionist, three intensivists, an anesthesiologist, an interventional cardiologist, four PICU nurses, a biomedical engineer, and two medical students.

The team of volunteers united in the Dominican Republic from 5 different countries, all joining together for 1 extraordinary cause:

32nd Mission to SantiagoNovember 8-22, 2014

to save the lives of children with congenital heart defects!

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Hospital Infantil RegionalUniversitario Dr. Arturo Grullon

Santiago,Dominican Republic

Abdiela Batista2 years old

VSD & PFO Closures, PDA Ligation

Jean Lindor11 years old

Mitral Valve Replacement

José Puello21 months old

AP Window Repair, ASD & VSD Closures

Laury Vidal 20 years oldTOF Repair

Miranda Sanchez2 years oldTOF Repair

Yovanna Genao6 months oldTAPVR Repair

Marianny Vargas4 years oldASD Closure

Ricardo Mendoza10 years oldASD Closure

Sebastian Figueroa2 months old

Hemitruncus Repair

Frank Ramirez6 years oldTOF Repair

Jensley Henry 1 year old

VSD Closure, PDA Ligation

Franchesca Marte9 months old

ALCAPA Repair

Frankely Auguste15 years old

Mitral Valve Replacement

Elido Rondon5 years oldTOF Repair

Mitcheny Lius13 years old

Mitral Valve Replacement

Babyheart Patients

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Franchesca is an adorable 8-month-old girl whose mother took her to the doctor’s office for a simple cold in October of 2014. The doctors took an x-ray of her chest and discovered that she had an enlarged heart. She was referred to Dr. Ramirez, a pediatric cardiologist in Santiago, Dominican Republic. He performed an echocardiogram on Franchesca and diagnosed her with an anomalous left coronary artery arising from the pulmonary artery (ALCAPA). In a normally developed heart, the left coronary artery originates from the aorta and delivers oxygenated blood to the heart muscle itself. In Franchesca’s case, her left coronary artery was delivering non-oxygenated blood to her heart muscle instead. If left unrepaired, this anomaly will cause irreversible damage to the heart. Due to the late diagnosis of her defect, her heart was extremely weak - so weak that it could have stopped functioning at any time.

Fortunately for Franchesca, the Babyheart medical team was scheduled to be in Santiago the following month. Upon the team’s arrival, she was evaluated and was immediately booked for surgery the first week. While an ALCAPA repair may not be the most difficult surgery to perform, ICHF surgeon Dr. Soto stated that this was the “riskiest surgery we did the entire trip, because her heart was so weak.” Anytime the heart is weak, there is always a greater risk associated with it functioning properly after being on bypass.

Thankfully for Franchesca, she did great! Her surgery went well, and her heart was strong enough to pump on its own after bypass. She did not have any major

complications during surgery and her recovery in the ICU was swift. In fact, she was able to leave the ICU only three days after her open-heart surgery! Before the Babyheart team departed from Santiago, Franchesca was already at home with her family.

Her family felt so blessed that ICHF was able to come to Santiago so quickly after her baby’s diagnosis. This was a scary time for her mother and her entire family, but they are very thankful and grateful to everyone who helped save her baby girl!

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Meet Franchesca!

Frankely is a 15-year-old boy from Cabaret, Haiti who suffered from severe mitral valve regurgitation, secondary to rheumatic fever. Rheumatic fever causes direct damage to the leaflets of the heart valves and is a common childhood disease in developing countries, where antibiotic treatment is not easily accessible for certain infectious diseases, such as those that cause rheumatic fever.In January of 2014, Frankely’s mother began noticing that his stomach was large, and his legs and feet were swollen. She made contact with CHADASHA, which is known in the Haitian community as being a link to organizations that treat heart disease. Haiti Cardiac Alliance partners with

CHADASHA and ICHF to provide diagnosis, screening, medical management, and surgical scheduling to Haitian children suffering from heart disease. Together, they were able to get Frankely into a screening clinic in Port Au Prince where he was diagnosed with congestive heart failure due to his incompetent valve. After two centers in the US turned him down, Haiti Cardiac Alliance brought Frankely to an ICHF/CHADASHA medical mission trip in Jimani, Dominican Republic in July of 2014. It was there that Frankely almost lost his fight altogether. He developed pneumonia prior to the trip, and when he arrived to Jimani, he was immediately hospitalized in the ICU. He had many “touch and go” nights, but he pulled through and eventually recovered enough to go back to Haiti and hope for another opportunity for life-saving surgery. He got that chance on this ICHF medical mission trip to Santiago. Frankely and his mother made the 10-hour journey from Porta Au Prince, Haiti to Santiago, Dominican Republic, while his two older siblings stayed behind, hoping for the best.On November 14, Frankely received his life-saving surgery! The local surgeon in Santiago, assisted by ICHF volunteer surgeon Dr. Absi, replaced Frankely’s mitral valve with a mechanical St. Jude valve. His surgery was uncomplicated, and he recovered quickly in the ICU. He was back to drawing cartoons and making designs the next day. With his new valve, Frankely will need to take a medication called Warfarin (Coumadin) for the rest of his life. Warfarin prevents blood clots from forming around the valve. Thanks to Haiti Cardiac Alliance, Frankely has a portable INR machine he uses to monitor his blood levels, and he has a nurse in Haiti that follows up with him every 2-3 weeks.Frankely is a great example of the partnership between these three NGO’s and the heroic efforts that go into making sure these children receive the care they need.

ICHF is proud to have CHADASHA and Haiti Cardiac Alliance partnering with us in Haiti!

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Meet Frankely!

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LEAD SURGEONRodrigo Soto

Chile

INTERVENTIONAL CARDIOLOGISTDamien KennyUnited States

ANESTHESIOLOGISTVancho Jovanov

Macedonia

PICU NURSEClaire SorensenUnited States

PICU NURSEAndrea Maurich

Canada

INTENSIVISTMohammad Hamzah

United States

STUDENT VOLUNTEERKelby WegnerUnited States

SURGEONDaniel AbsiArgentina

PERFUSIONISTChristopher Yann

United States

PICU NURSESuk LoCanada

PICU NURSEGricel Pereira

Chile

INTENSIVISTSwati AgarwalUnited States

INTENSIVISTJuan Boriosi

United States

BIOMEDICAL ENGINEERRoy Morris

United States

Kindhearted Medical Volunteers

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Dr. Rodrigo SotoCEO, Clinical Operations

As the new CEO of Clinical Operations for International Children’s Heart Foundation, Dr. Rodrigo Soto is passionately committed to our mission of providing free pediatric cardiac surgeries to children around the world, while also empowering local medical professionals with training and medical resources.

A seasoned pediatric cardiac surgeon, Dr. Soto supervises all of our clinical operations, including our compliance to the global regulations, standards and statutes required for developing cardiac care programs in emerging nations. Additionally, Dr. Soto diligently works to expand the foundation’s reach by recruiting qualified medical volunteers, developing new global partnerships and fortifying existing worldwide alliances with sponsors, health care institutions and likeminded organizations.

Prior to his current position as CEO, Dr. Soto has dedicated his time, passion and expertise to ICHF for over a decade, serving as a volunteer pediatric cardiac surgeon from 2002 to 2012, before transitioning to staff surgeon in early 2013. Before teaming with ICHF, Dr. Soto worked as staff pediatric cardiac surgeon at Royal Children’s Hospital in Melbourne, Australia from 2001 to 2003, and he was the pediatric cardiac surgery unit director and ECMO program director from 2004 to 2012 at Clínica Alemana in Santiago, Chile.

Dr. Soto received his MBBS degree from the University of Chile School of Medicine in 1990 and completed residencies in general and cardiac surgery at Luis Calvo Mackenna Children’s Hospital in Santiago, Chile, followed by fellowships at the Royal Children’s Hospital, and the Pediatric Cardiac Unit at Hôpital Marie Lannelongue in Paris, France.

The International Children’s Heart Foundation assembles volunteer medical teams from around the world to provide free pediatric cardiac surgeries, training and medical resources to countries that do not have access to them. We strive to build sustainable pediatric cardiac programs by operating with and educating local healthcare professionals in their own hospitals. We use a variety of educational models, including formal lectures, simulation and clinical teaching. Babyheart also assists with medication and equipment as needed and can provide resources to help with organizational change in the centers that we teach.

With the training and knowledge that we provide, the local teams progressively acquire the skills necessary to cure and care for their children independently.

Training & Education

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Heartfelt Thank You!

Special Thanks to

Babyheart sincerely thanks you for your support! Your generosity allowed us to provide free pediatric cardiac operations to 15 children with congenital heart disease during this trip. You also helped make it possible for us to give priceless knowledge and training to the local medical team in Santiago, which will aid and fortify them during their progression into a self-sustaining, lifesaving program. Thanks to your kindhearted help, we are able to continue our mission of curing and caring for children with cardiac defects all over the world!

Heartfelt Thank You!

INTERNATIONAL CHILDREN’S HEART FOUNDATION80 MONROE AVENUE, SUITE G1 • MEMPHIS, TENNESSEE 38103

WWW.BABYHEART.ORG • PHONE: 877.869.4243 • FAX: 901.432.4243

2015Mission Schedule

February 28-March 14: Guayaquil, EcuadorMarch 14-22: Santiago, Dominican Republic

April 11-18: Asuncion, ParaguayApril 25-May 9: Guayaquil, Ecuador

May 9-June 23: Santiago, Dominican RepublicJune 20-July 4: Guayaquil, Ecuador

August 1-8: Asuncion, ParaguayAugust 15-29: Guayaquil, Ecuador

August 22-Sept 5: Santiago, Dominican RepublicSeptember 5-19: Mirebalais, HaitiOctober 3-17: Guayaquil, Ecuador

November 7-21: Santiago, Dominican RepublicDecember 5-19: Guayaquil, Ecuador