Nigeria 2022 Mission Report 

On October 8th, 2022, CardioStart International embarked on one of our most collaborative efforts to date in Nigeria with two of our valued University hospital partners, advancing 3 distinct programs in 2 different states: University of Nigeria Teaching Hospital in Enugu (UNTH) and Lagos State University Teaching Hospital in Lagos (LASUTH).  

Fourteen volunteers from six different countries came together to represent CardioStart in these important cardiovascular program-building missions. Alongside our local colleagues, we were able to accomplish 31 cardiac procedures together for indigent patients, as well as countless evaluations, surveillance studies, diagnostic and treatment plans for both surgical and non-surgical patients with structural, congenital, acquired, and rheumatic valvular heart disease.  

Beginning at UNTH, our focus was to complete a comprehensive safety and readiness assessment, as well as recommence cardiac surgery in Enugu. Several years of inactivity were initially obligated to allow clinicians positioned as the future of the program to acquire advanced training overseas; this pause was then amplified and prolonged by the covid pandemic.  

Sponsored by CardioStart, Dr. Ndubueze Ezemba trained in-residence with CardioStart Board member Dr. Vinicius Nina at the Federal University of Maranhao in Sao Luis, Brazil. Upon his return home to UNTH, he was designated as Director of the National Cardiothoracic Center of Excellence at the University of Nigeria and eager to reinvigorate the program with ongoing partnership from CardioStart International. 

Additionally, we were pleased to enrich our established partnership with LASUTH, the University program located in Lagos, the most populous city on the entirety of the African continent. CardioStart’s continued relationship with the Cardiac Surgical program at LASUTH has been one of our most rewarding collaborations.  It’s been a privilege to watch their team progress to a respected program regularly performing cardiac surgery independently in the community. 

Further, they are paying it forward in following the CardioStart format of skill transfer through a ‘locals helping locals’ platform; the LASUTH team has traveled to several satellite locations in Nigeria to assist and empower other colleagues as they establish and grow their own surgical programs.

One additional effort we’ve encouraged & supported financially has been the commencement and maintenance of a national registry of cardiac surgical procedural data for the entire country, spearheaded by Dr. Bode Falase at LASUTH and the Association of Cardiovascular and Thoracic Surgeons of Nigeria. 

We enjoyed working together again on advanced skills in only uniquely complex surgical cases this visit, while also reinforcing our Cardiac Critical Care curriculum that was conducted with both nurses and physicians from the LASUTH team during the pandemic. strengthening access to comprehensive cardiovascular care at LASUTH.   

Finally, with the desire to replicate the ‘Heart Team’ model adapted & valued by contemporary CV programs around the world, we brought a specialist team to support the establishment of a new Cardiac Catheterization lab at LASUTH for percutaneous coronary, structural heart, and electrophysiological care. It was an outstanding collaboration between both the LASUTH Cardiac Surgical & Cardiology teams together with CardioStart International, laser-focused on optimizing access to multidisciplinary and comprehensive cardiovascular care in Nigeria. 

 

 

Procedures
PATIENT NAME	AGE	PROCEDURE	OUTCOME
P.R.	26	Mitral Valve Replacement	Satisfactory
T.A.	46	Redo Sternotomy, Mitral Valve Replacement	Satisfactory
O.O.	22	Tetralogy of Fallot, Total Correction	Satisfactory
A.A.	27	Partial AV Canal with Mitral Valve Repair, VSD closure	Satisfactory
M.B.	44	Resection of Myxoma Tumor, Mitral Valve Replacement	Satisfactory
O.B.	61	Dual Chamber Pacemaker Insertion	Satisfactory
O.C.	54	Dual Chamber Pacemaker Insertion	Satisfactory
I.F.	51	Percutaneous Coronary Intervention	Satisfactory
A.T.	48	Percutaneous Coronary Intervention	Satisfactory
A.I.	44	Coronary Angiogram	Satisfactory
I.M.	43	Percutaneous Coronary Intervention	Satisfactory
M.E.	52	Coronary Angiogram	Satisfactory
A.J.	51	Dual Chamber Pacemaker Insertion	Satisfactory
M.O.	39	Implantable Cardioverter Defibrillator Insertion	Satisfactory
O.K.	44	Coronary Angiogram	Satisfactory
A.K.	51	Coronary Angiogram	Satisfactory
M.N.	53	Implantable Cardioverter Defibrillator Insertion	Satisfactory
O.I.	60	Dual Chamber Pacemaker Insertion	Satisfactory
O.J.	55	Coronary Angiogram	Satisfactory
O.A.	49	Coronary Angiogram	Satisfactory
T.A.	62	Coronary Angiogram	Presentation with acute STEMI; cardiac arrest prior to definitive intervention
A.B.	43	Cardiac Resynchronization Therapy-Defibrillator Implantation	Satisfactory
O.S.	38	Implantable Cardioverter Defibrillator Insertion	Satisfactory
O.K.	56	Percutaneous Coronary Intervention	Satisfactory
B.C.	48	Coronary Angiogram	Satisfactory
B.E.	41	Percutaneous Mitral Valvuloplasty	Satisfactory
I.M.	36	Cardiac Resynchronization Therapy-Defibrillator Implantation	Satisfactory
T.T.	45	Dual Chamber Pacemaker Insertion	Satisfactory
A.P.	50	Coronary Angiogram	Satisfactory
O.L.	53	Coronary Angiogram	Satisfactory
O.R.	58	Dual Chamber Pacemaker Insertion	Satisfactory
A.A.	44	Cardiac Resynchronization Therapy-Defibrillator Implantation	Satisfactory

 

Volunteers

Cardiac Surgery:  Emily A. Farkas, MD; USA Vinicius Nina, MD; Brazil	Cardiology:  Rafel Atassi, M.D; USA Yuri Pride, MD; USA Hikmat Kabbani, MD; USA
Anesthesiology: Reza Yusoff, MD; Australia	Nursing:  Jenna Lee, BSN; Canada Danza Pereira, BSN; Canada Andrew Starenko, CRNFA; USA
Biomedical Engineering:  Amos Dantene, BMET; Ghana	Perfusion:  Ariyo Idowu, CCP; Nigeria
Catheterization / Electrophysiology Lab: Laura Pride, PA-C; USA Daniel Bisch, BSN; USA Jon Cummings, BS; USA

We would also like to recognize our outstanding colleagues and teammates led by Dr. Ezemba @UNTH, and Dr. Falase & Dr. Oladimeji @LASUTH; it’s a privilege working together to magnify the impact we can achieve in Nigeria by strategizing in the humanitarian sector.

                    

Acknowledgements

While we have countless generous donors who make these efforts possible, we feel especially indebted to Edwards Lifesciences Foundation for their ‘Every Heartbeat Matters’ initiative which continues to provide overwhelming support of our efforts and those of so many other organizations bringing quality cardiovascular care to every corner of the global surgical space.  

Additionally, this mission would not have been possible without the continued gracious support from Medtronic in facilitation of prosthetic heart valve & implantable cardiac device procurement. 

Finally, special thanks to Pace4Life with appreciation to Dr. Joel Dunning for the donation of several dual chamber pacemaker devices. 

Our overwhelming thanks to all who have generously donated & supported our programs at CardioStart International