Our First Exploratory Surgical-Educational Mission to Paraguay
Cardiovascular disease is the leading cause of death worldwide, and there are many different types of heart disease. Today, Heart to Heart wants to bring awareness to valvular heart disease, the primary focus of our latest training mission. From April 3-13, 2019 a Heart to Heart team of cardiac specialists conducted an exploratory surgical-educational mission at National Hospital in Asuncion, Paraguay. Our primary focus was to raise awareness about valvular disease and explore the possibility of a long term collaboration to expand and advance treatment. Thanks to the donation of state-of-the-art heart valves from Edwards Lifesciences and Americares, the joint Heart to Heart-Paraguayan team was able to perform surgery and save the lives of four adults, ranging in age from 23-63 years of age. Scroll to see our volunteers in action!
National Hospital in Asuncion, Paraguay
The nation’s capital, Asuncion, is home to half a million people and the nation’s only medical school. It serves as the hub of healthcare for this country of nearly 7 million. Heart to Heart first visited National Hospital in April 2018, when founder & medical director Nilas Young and executive director Josie Everett met with Paraguayan cardiac specialists, hospital administrators, and ministry of health officials to learn about the hospital and discuss A potential collaboration to expand and advance heart care nationwide.
Exploring collaborative opportunities
Members of our joint Heart to Heart-Paraguayan team, left to right, back row to front row Gustavo Escalada, MD; Stuart Grant-Coons; perfusionist, Susana Noel, RN, ICU nurse; Debbie Lewis, surgical technician; Aubrey Yao, MD, anesthesiologist, Dali Fan, MD, cardiologist; Andrew Studin, OR/circulating nurse; Josie Everett, Heart to Heart executive director; Brigid Culey, echosonographer; Lucia Nuñez, Yolanda González, MD; Estela Torres, MD; Nilas Young, MD, Heart to Heart founder & medical director; Sergio Cabral, MD, cardiac surgeon.
Family area at National Hospital
Undergoing heart surgery can require a lengthy hospital stay. National Hospital provides families with small patios where they can wash and hang their clothes while their children are receiving treatment. Patients travel from all over the country to obtain medical help here.
Working together to determine best course of treatment
Heart to Heart medical volunteer Dali Fan, MD performs a transesophageal echocardiogram on a post-operative heart patient with the assistance of echosonographer Brigid Culey. An echocardiogram provides the team with pictures of the heart’s valves and chambers, helping to serve as part of a blueprint that helps us determine the best course of treatment. On this trip 46 echocardiograms were performed on patients ranging in age from 17 to 94 years old.
Sharing more than just knowledge
Head operating room nurse Maria Dure receives surgical hats for the nursing staff as a gift from Heart to Heart volunteer Debbie Lewis. The two worked closely together for more than 30 hours in the operating room. Five open heart surgeries were conducted by the joint Heart to Heart-Paraguayan team. Hands-on teaching and training between Heart to Heart medical volunteers and the site’s cardiac team provides the transfer of foundational knowledge to help advance their cardiac program.
Saving lives in real time
Sergio Cabral, MD assists Heart to Heart’s Nilas Young, MD during open heart surgery to replace a patient's native heart valve with a bioprosthetic Edwards Lifesciences valve during a surgical-educational mission dedicated to the treatment of valvular disease.
The intricacies of the heart
Intraoperative view of a valve and root replacement graft procedure, which took over 10 hours to complete. The operation was led by Nilas Young, MD working side-by-side with the host Paraguayan team, four Heart to Heart team members, and three interpreters. The photo represents a final view before closing the patient’s chest.
Placement of a state-of-the-art bioprosthetic heart valve
Heart to Heart’s exploratory surgical-educational mission in Paraguay began with a double valve replacement operation. Shown here: an Edwards Lifesciences bioprosthetic aortic heart valve is about to be lowered into position (from upper left), replacing the patient’s dysfunctional native valve.
Patients of all ages suffer from valve disease
(Left to right) Paraguayan cardiology resident Nancy Caceres, MD; Heart to Heart cardiac surgeon Nilas Young, MD with young valve patient Mabel (center); and Paraguayan cardiac surgeon, Sergio Cabral, MD one day before Mabel’s valve replacement operation. At 23 years old, Mabel, our youngest patient on this trip, was suffering from severe mitral valve regurgitation due to rheumatic heart disease.
The opportunity for expanding heart surgery to children in Paraguay
Heart to Heart was encouraged to develop a long term educational collaboration to establish a pediatric cardiac surgery program at the National Hospital. The hospital has adequate pediatric and neonatal departments to support a heart program. Local physicians expressed great enthusiasm at the prospect of being able to save children born with heart defects. We are excited at the prospect of a Heart to Heart collaboration with National Hospital and its dedicated cardiac specialists!