Program Progress: Optimizing patient selection for Costa Rican children with CHD
Doctors Frank Cetta (left) and Gary Raff (right) perform an echocardiogram on a post-operative pediatric patient in the intensive care unit at HNN.
Costa Rica’s national mascot—the sloth—welcomes travelers at Juan Santamaria International airport in San Jose, the country’s capital city.
In July 2024, Heart to Heart conducted a highly focused training mission at the National Children’s Hospital (HNN), specifically to re-evaluate the patients on their cardiac surgical waiting list, which had ballooned to more than 100 children. Optimizing patient selection is key to developing HNN’s children’s heart program. It is one of four pillars the joint Heart to Heart-HNN team has adopted to guide our educational collaboration.
Longtime Heart to Heart medical volunteers Drs. Frank Cetta and Gary Raff led the joint Heart to Heart-HNN team in reclassifying many patients. Some children will be best served through palliative care, and others can undergo definitive repairs through interventional catheterization rather than open heart procedures. The comprehensive review of these complicated patient cases provided many valuable teaching moments.
Nilas Young, MD, Heart to Heart Founder & Medical Director, and Josie Everett, Senior Advisor for Strategic Initiatives, held several meetings with HNN leadership and department leads to discuss strategic next steps for streamlining the children’s heart program.
Additionally, cardiac surgeon Gary Raff worked alongside HNN chief of cardiac surgery Karla Castro to guide her through her very first hands-on repair as lead surgeon of an atrioventricular septal defect (also known as AVSD or AV Canal). Dr. Raff highlighted surgical techniques key to performing this and several other cardiac operations. The week following Heart to Heart’s departure, Dr. Castro successfully performed another AVSD operation, this time leading it completely on her own!
We continue to move forward enthusiastically with the goal of expanding and advancing cardiac care for all children in Costa Rica. A special thanks to Lucie Everett and Hernan Carcamo, MD for their excellent interpreting work, which facilitated communication at all levels.
