REPORT on CARDIAC MISSION to SANTO DOMINGO, DOMINICAN REPUBLIC

March 30-April 6, 2019

This mission was CardioStart’s 6^th adult cardiac surgery mission to Clinica Corozonas Unidos, in Santo Domingo.  HeartCare Dominicana, Inc. facilitated the team’ presence during the week and arranged for patients to be seen for this humanitarian surgical program.   Several complex valve repairs/replacements were performed with intensive involvement with the local team.  In addition to the surgical program catheterization lab procedures were performed including a valvuloplasty saving the patient from having to undergo open-heart surgery. 

  

CARDIAC PATIENTS & PROCEDURES

Name	Age	Surgical Procedure	Outcome
R.T.	55	Severe MS, RHC (Right heart cath) LHC (Left heart cath)	Satisfactory
J.A.C.	65	Severe MR RHC, LHC	Satisfactory
B.C.	55	Severe MR, dilated cardiomyopathy, LHC, RHC	Satisfactory
E.G.R.	59	MS, MR (Rheumatic) RHC, LHC	Satisfactory
A.N.	43	Severe MR, RHC & LHC	Satisfactory
R.P.	72	Severe AS, LHC & RHC	Satisfactory
R.C.	39	Severe MR, LHC & RHC	Satisfactory
A.N.	43	Severe MR, Mitral Valve Repair, extensive leaflet reconstruction and annuloplasty	Satisfactory
D.I.	73	Severe AS and CAD; AVR & CABG	Satisfactory
A.R.	51	Severe MR; mitral valve replacement with bio-prosthetic  valve	Satisfactory
D.B.	21	Severe MR & AI; AVR and MV replacements with bio-prosthetic valves	Satisfactory
M.A.	22	Ostium Secundum ASD; ASD repair with autologous pericardial patch	Satisfactory
D.C.	70	Severe CAD; CABG x 4	Satisfactory
R.C.	39	Severe MR with severe pulm. HTN; MV repair with extensive posterior leaflet reconstruction and annuloplasty repair	Satisfactory
R.O.	73	Severe AS & CAD; AVR with bio-prosthesis and CABG	Satisfactory
E.G.	67	Dilated Cardiomyopathy; ICD implantation	Satisfactory
M.P.	44	Dilated cardiomyopathy ICD Implantation	Satisfactory
L.F.	54	Dilated Cardiomyopathy; ICD implantation	Satisfactory
R.T.	55	Severe MS (Rheumatic); percutaneous valvuloplasty in cath lab	Satisfactory
B.C.	55	Severe MR; mitral valve repair with annuloplasty ring repair	Satisfactory

OUTREACH PROGRAM

A cardiology clinic was held in Cabrera, Dominican Republic.  This community is a 2.5-hour drive across the island from Santa Domingo.  Patients were lined up 2-hours before the team was to arrive.  In two days, three medical providers, (Glenda Campbell echo tech, Linda Romeo Family Nurse Practitioner and Tom Cocke cardiologist) and medical student translators evaluated and treated 117 patients for cardiac conditions with seven referred for possible future surgery.  Echocardiograms were performed on 17 patients.

COLLABORATION & TEACHING

On every CardioStart mission, education of local practitioners is priority.

This year teachers from the California Medical Training Center provided 3 days of education to local practitioners in resuscitation and associated skills in both lecture and laboratory settings. 

CardioStart Nurse Practitioner Linda Romeo provided an afternoon of nursing education.

Teaching in all aspects of the cardiac patient care was provided at the bedside during patient treatment and recovery.  Translators from the local school of medicine provided translation skills and received observational education in return.

CATHETERIZATION LABORATORY

During the weekend pre-mission Cardiologist Dr. Tom Cocke with the assistance Anesthesiologist Jeff Levine performed seven cardiac catheterization procedures, some patients then referred for the surgical program during the week. 

Three cardiac defibrillators were implanted during the week due to the generosity of Medtronic Inc. n interventional catheterization lab procedure; Percutaneous valvuloplasty was performed by Dr. Cocke saving the patient from an open-heart procedure.

CARDIOSTART TEAM

NAME	PROFESSION	TEAM POSITION	HOME
Mariano Brizzio, MD	Adult CV Surgeon	Mission Director	New Jersey, USA
Hina Solanka	Perfusion	Perfusionist	Leicester, UK
Jeff Levine, MD	Adult CV Anesthesia	Anesthesiologist	New Jersey, USA
Rosana Brizzio	Non-medical	Database scribe	New Jersey, USA
Alicia Smith, RN	Operating Room Nurse	Scrub Nurse	New Jersey, USA
Elaine Kletsman, PA	Physician Assistant	Physician Assistant	New Jersey, USA
Tom Cocke, MD	Interventional Cardiology	Interventional Cardiologist	New Jersey, USA
Linda Romeo, ACNP	Family Nurse Practice	Adult ICU practitioner	New Jersey, USA
Minerva Manali, RN	Adult CV ICU Nurse	Adult CV ICU Nurse	New Jersey, USA
Emma Staniels, RN	Adult CV ICU Nurse	Adult CV ICU Nurse	New Jersey, USA
Kerrie Miller, RN	Adult CV ICU Nurse	Adult CV ICU Nurse	Oregon, USA
Glenda Campbell, RDCS	Echocardiographer	Echocardiographer	Illinois, USA
Elissa Persaud, RN	Adult CV ICU Nurse	Adult CV ICU Nurse	Michigan, USA
Janine Henson, RN	Adult CV ICU Nurse & VP CardioStart	Mission Coordinator	Minnesota USA
Tom Hilton, MD	Adult Cardiologist	Adult Cardiologist	Florida, USA
Diana Turrell, RDCS	Echocardiographer	Echocardiographer	California, USA
Michael Pyorala, RT	Respiratory Therapist	Educator	California, USA
Justin Pyorala, RT	Respiratory Therapist	Educator	California, USA
Naiomi Sanchez, RT	Respiratory Therapist	Educator	California, USA

RESEARCH FOLLOW-UP

Twelve patients were examined as follow up from previous mission treatment and interviewed as part of the CardioStart patient database research project. Seven echocardiograms were performed in the follow up program.  This program examines many areas of quality of care and aspects of impact to patient health and recovery by poverty and cultural differences.

It not only documents care provided but also quality of life and survival after cardiac surgery in a developing country.  We are thankful for these patients for taking the time to come to the city for evaluation.

THANK YOU!

CardioStart gratefully acknowledges the generous contributions of the following:

• Valley Hospital, Ridgewood New Jersey USA
• Valley Hospital Foundation, Ridgewood New Jersey, USA
• St. Jude Medical Minneapolis, MN USA.
• Heartcare Dominicana Inc. Santo Domingo, Dominican Republic
• Clinica Corazones Unidos, Santo Domingo, DR.
• Amy Lauth Foundation, Georgia, USA (Logistics and suitcase donation items).
• Medtronic USA, Minneapolis, MN, USA.
• Essential Pharma, Inc, USA.
• United Methodist Church, Lake Oswego, OR, USA) (Patient heart pillow & hygiene gifts)
• Maxine Rodgers- Hygiene Care Kits for patients, Chico, CA, USA.
• Johnson & Johnson Health Care Systems, Inc.  USA
• Cal Med Training Center, Mission Hills, CA, USA
• Translators from the medical Schools in Santo Domingo, DR
• Abbott Laboratories, IL USA
• LSI Solutions, New York, USA
• Terumo Inc. MI, USA
• Toray Innovations for Valvuloplasty devices, USA
• Paramus, NJ Rotary Club