Healing Hearts Northwest Completes Heart Surgery at King Faisal Hospital
A chance encounter in June of 2008 lead to an invitation for Healing Hearts Northwest to come to Kigali. The co-medical director of the team, Dr. Hal Goldberg, was in Kigali on an exploratory medical mission, working at Kibagabaga Hospital. Dr. Goldberg visited King Faisal where he met Dr. Joseph Mucumbitsi, coordinator of the cardiac surgery program at King Faisal Hospital Faisal. That conversation laid the plans for the return of the a team that comprised 54 people including two surgeons, 9 physicians, perfusionists, respiratory therapists, an echo technician, a biotehchnician, pharmacist, and specialists in physical therapy, public health and social work.
Operating on sixteen patients with heart problems at King Faisal Hospital was a goal established by a team from Spokane, Washington in the United States. The work of teams that preceded them, Chain of Hope from Belgium, Operation Open Heart from Australia, and Team Heart from Boston served as a model for how to accomplish this important work. Patients ranged in age from eight to thirty-two and most had problems with their heart valves caused by prior damage from rheumatic fever. The youngest patients, however, had problems since birth, a condition known as congenital heart disease.
Healing Hearts began official planning of our team composition in April 2009, shortly after Dr. Hal Goldberg returned from observing the Boston Team. Team members are from three different hospitals in Spokane and from three different physician groups.
Planning included a team of medical professionals and grant writers who established our goals, raised money, procured supplies and equipment, and prepared staff.
Critical equipment to perform heart surgery including an open heart machine and heart monitors had been left at King Faisal Hospital by these prior teams. However, preparing this equipment to transform both the operating room and intensive care unit into a functioning cardiac unit is a complex task. Ten people arrived on Friday February 6 to begin the process of unpacking 220 boxes of medical equipment weighing 2750 kilograms, all designed to support this surgical work and the care required following heart surgery. Additional members of the team arrived over the next 48 hours, assisting in readying the operating room and intensive care unit for the first case, beginning Monday, February 8.
The true test of the preparations is always the first case. The young woman, age twenty six, had been short of breath for several years due to a leaky heart valve and a hole in heart. The heart surgeon Dr. Leland Siwek successfully replaced her mitral valve and closed the hole. Returning to the Intensive Care Unit under the direction of Michelle Dearden, R.N., she was quickly removed from the breathing machine, awakening to be greeted by her sister. The second case, a ten year old girl born with a condition in which a piece of cardiac tissue known as a membrane blocked the flow of blood leaving her heart, was operated upon by Dr. Neil Worrall. Removal of that membrane will allow her to lead a normal life. In fact, she will be returning to school in two weeks, emphasizing the ability of children to recover quickly from heart surgery.
With the first two surgeries successfully completed, there was a sense of relief for the whole team, knowing that preparations over the course of nine months had been well worth it. Surgery over the next eight days moved along with two cases a day, each case taking an average of four hours. While most patients with heart valve problems received artificial heart valves, some were able to have their heart valves repaired. Repairing the valve is preferable, as there are fewer problems in the future. However, not every individual has a valve that can be repaired, due to the underlying damage that has been done to the valve by prior rheumatic fever. Valve repair requires specialized techniques and the surgeons from Spokane are highly trained to perform this work.
In addition to treating rheumatic heart disease, Dr. Joseph Mucumbitsi, chairman of the Rwandan Heart Foundation and cardiac pediatrician at King Faisal Hospital, is developing a program to work on preventing rheumatic fever, which can lead to rheumatic heart disease. Healing Hearts Northwest and other international surgical teams have been asked to help explore the possibility of screening for rheumatic heart disease, in order to determine the disease prevalence in Rwanda and develop appropriate policies and prevention programs. Such programs will help prevent the severe heart disease seen in Rwanda today.