PMID- 24728579
OWN - NLM
STAT- MEDLINE
DCOM- 20150731
LR  - 20211021
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Linking)
VI  - 38
IP  - 9
DP  - 2014 Sep
TI  - Partnership for sustainability in cardiac surgery to address critical rheumatic 
      heart disease in sub-Saharan Africa: the experience from Rwanda.
PG  - 2205-11
LID - 10.1007/s00268-014-2559-2 [doi]
AB  - IMPORTANCE: Rheumatic heart disease (RHD) in the developing world results in 
      critical disability among children, adolescents, and young adults-marginalizing a 
      key population at its peak age of productivity. Few regions in sub-Saharan Africa 
      have independently created an effective strategy to detect and treat 
      streptococcal infection and mitigate its progression to RHD. OBJECTIVE: We 
      describe a unique collaboration, where the Rwanda Ministry of Health, the Rwanda 
      Heart Foundation, and an expatriate humanitarian cardiac surgery program have 
      together leveraged an innovative partnership as a means to expand Rwanda's 
      current capacity to address screening and primary prevention, as well as provide 
      life-saving cardiac surgery for patients with critical RHD. EVIDENCE REVIEW: 
      Interviews with key personnel and review of administrative records were conducted 
      to obtain qualitative and quantitative data on the recruitment of clinical 
      personnel, procurement of equipment, and program finances. The number of surgical 
      cases completed and the resultant clinical outcomes are reviewed. FINDINGS: From 
      2008 to 2013, six annual visits were completed. A total of 128 prosthetic valves 
      have been implanted in 86 complex patients in New York Heart Association (NYHA) 
      class III or IV heart failure, with excellent clinical outcomes (5 % 30-day 
      mortality). Postoperative complications included a cerebrovascular accident (n = 
      1) and hemorrhage, requiring reoperation (n = 2). All procedures were performed 
      with participation of local personnel. CONCLUSIONS AND RELEVANCE: This strategy 
      provides a reliable and consistent model of sophisticated specialty care 
      delivery; inclusive of patient-centered cardiac surgery, mentorship, didactics, 
      skill transfer, and investment in a sustainable cardiac program to address 
      critical RHD in sub-Saharan Africa.
FAU - Swain, JaBaris D
AU  - Swain JD
AD  - Department of Surgery, Division of Cardiac Surgery, Brigham and Women's 
      Hospital-Harvard Medical School, Boston, MA, USA, jdswain@partners.org.
FAU - Pugliese, Daniel N
AU  - Pugliese DN
FAU - Mucumbitsi, Joseph
AU  - Mucumbitsi J
FAU - Rusingiza, Emmanuel K
AU  - Rusingiza EK
FAU - Ruhamya, Nathan
AU  - Ruhamya N
FAU - Kagame, Abel
AU  - Kagame A
FAU - Ganza, Gapira
AU  - Ganza G
FAU - Come, Patricia C
AU  - Come PC
FAU - Breakey, Suellen
AU  - Breakey S
FAU - Greenwood, Bonnie
AU  - Greenwood B
FAU - Muehlschlegel, Jochen D
AU  - Muehlschlegel JD
FAU - Patton-Bolman, Cecilia
AU  - Patton-Bolman C
FAU - Binagwaho, Agnes
AU  - Binagwaho A
FAU - Morton Bolman, R
AU  - Morton Bolman R
LA  - eng
GR  - T32 HL007734/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Capacity Building/*organization & administration
MH  - Delivery of Health Care/economics/*organization & administration
MH  - Female
MH  - Foundations
MH  - Government Agencies
MH  - *Heart Valve Prosthesis Implantation/adverse effects/education
MH  - Humans
MH  - Male
MH  - Mentors
MH  - Middle Aged
MH  - Patient Selection
MH  - *Program Evaluation/economics
MH  - Public-Private Sector Partnerships/economics/*organization & administration
MH  - Rheumatic Heart Disease/diagnosis/prevention & control/*surgery
MH  - Rwanda
MH  - Surgical Equipment/supply & distribution
MH  - Treatment Outcome
MH  - Workforce
MH  - Young Adult
EDAT- 2014/04/15 06:00
MHDA- 2015/08/01 06:00
CRDT- 2014/04/15 06:00
PHST- 2014/04/15 06:00 [entrez]
PHST- 2014/04/15 06:00 [pubmed]
PHST- 2015/08/01 06:00 [medline]
AID - 10.1007/s00268-014-2559-2 [doi]
PST - ppublish
SO  - World J Surg. 2014 Sep;38(9):2205-11. doi: 10.1007/s00268-014-2559-2.