Report of CardioStart International’s 8th Mission to Komfo Anokye Teaching Hospital

Kumasi, Ghana

In January 2020, twelve CardioStart International volunteers from six different countries participated in an ongoing cardiovascular program-development effort at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Skill-transfer in both adult Cardiac Surgery and Electrophysiology were the focus of this visit, furthering our commitment to medical education at this important and strategically located training institution in West Africa.

Advanced cardiac care is not accessible to the majority of the 34 million residents of Ghana. Apart from KATH, there is a single center in the capital city of Accra that performs a small volume of cardiac cases annually, primarily serving patients who can afford the high cost.

Although CardioStart has conducted several missions to KATH in the past, a recent and promising collaboration with James Cook University in the UK supported primarily by Edwards Lifesciences has accelerated its progression toward independence. Key clinicians from KATH recently spent 1 month at the James Cook University Program in England to learn how a major cardiac center functions and to intensify training in each respective area of cardiovascular care.  Subsequently, a series of 4 missions in relatively quick succession over 12 months have been planned (with 2 completed) to establish patterns and protocols that maintain momentum directed at the creation of a sustainable service line.

         

During the January visit, CardioStart International collaborated with the local team to evaluate and treat approximately 75 patients. We assisted KATH clinicians in providing 11 patients with life-saving procedures:

• 4 Heart valve surgeries, including 2 double valve interventions
• 6 Dual chamber permanent pacemaker implantations
• 1 Internal cardioverter / defibrillator implantation

All patients recovered well from their procedures and were discharged from the hospital without incident.

Patient Initials	Age	Sex	Procedure
A.F.	50	M	Mitral Valve Replacement, Tricuspid Valve Repair
R.O.	67	F	Aortic Valve Replacement
J.A.	45	F	Mitral Valve Replacement, Tricuspid Valve Repair
A.A.	48	F	Mitral Valve Replacement
T.A.	84	M	Pacemaker Insertion
C.O.	68	F	Pacemaker Insertion
M.M.	76	F	Pacemaker Insertion
C.F.	75	F	Pacemaker Insertion
C.N.	83	F	Pacemaker Insertion
B.K.	75	F	Pacemaker Insertion
F.O.	49	F	Defibrillator Insertion

CardioStart International aims to support and enhance all aspects of a successful cardiovascular program, including surgical skill-transfer, anesthesiology & perfusion training, biomedical engineering & technical support, cardiology patient screenings, and CV-ICU nursing development.

Our nurses make some of our most important and lasting contributions to developing programs as they partner 24/7 at the bedside with local nurses to provide assistance, education, and guidance directed toward the care of a recovering surgical patient. On this mission, CardioStart nurses were able to collaborate in various settings, including caring for open heart surgery patients in the ICU, the ‘step-down’ unit for postoperative care, as well as telemetry monitoring following pacemaker and defibrillator procedures.

The team was thrilled to have Jonathan, a former patient from the 2014 CardioStart KATH mission return for a follow-up visit with his surgeon, Dr. Farkas. Prior to surgery, Jonathan had trouble being active and could barely sleep through the night because of difficulty breathing. Since his heart valve surgery in 2014, Jonathan’s life has drastically improved. He is now physically active and living a normal life. In the past 6 years since his operation, Jonathon has received a Master’s Degree in Education and is teaching economics at the High School level.  He has married and started a family; Jonathon and his wife welcomed a healthy baby girl named Ellie 11 months ago.

                              

CardioStart International – Ghana 2020 Team

• Emily Farkas, MD  (Mission Director, Cardiac Surgeon, USA)
• Vinicius Nina, MD  (Cardiac Surgeon, BRAZIL)
• Helen Oxenham, MD   (Cardiologist, UNITED KINGDOM)
• Felipe Bisbal, MD   (Electrophysiologist, SPAIN)
• Oluwaseun Oladokun, MD   (Anesthesiologist, NIGERIA)
• Ariyo Lookman Idowu, CCP   (Perfusionist, NIGERIA)
• Amos Dantene, BMT   (Biomedical Engineer, GHANA)
• Fran Younger, CST   (Surgical Technologist, USA)
• Jennifer Timberlake, RN (Charge Nurse, USA)
• Seana Lee Choe, RN   (CV ICU Nurse, USA)
• Brian Timberlake, BS   (Database Research Assistant, USA)
• Margaret Child, MPH   (Mission Coordinator, USA)

ACKNOWLEDGEMENTS

CardioStart International wishes to extend our sincere appreciation to all volunteers, donors and supporters, but would like to offer special thanks for this mission to:

• Edwards Lifesciences Foundation “Every Heartbeat Matters” initiative to combat the global burden of Rheumatic Heart Disease through partnership, grant support and product donation
  
• Medtronic for donation of dual chamber pacemakers, defibrillators and implantation supplies
  
• LivaNova International Fellowship for donation of perfusion supplies and biologic valves
  
• The supporters of Dr. Emily Farkas’ “Heart Surgery in West Africa” fundraiser
• Duke University Heart Center for the donation of surgical supplies
• Genesis Health Services Foundation for the donation of surgical supplies
• Budapest-Bamako Rally for endorsing CardioStart as an official event charity for fundraising
• Mr. Bahram Hashemi & Accuware Consultants for the donation and facilitation regarding acquisition of surgical supplies and equipment
• Shumsky Therapeutic Pillows for donation of pillows to assist with patient comfort after surgery