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Lessons from 19 Years of a Pediatric Heart Surgery Volunteer Program in Jamaica: Partnership, Teamwork, and
Sanjhai L Ramdeen1, Sherard G H Little2, Sharonne Forrester2
1Departments of Surgery and Pediatrics, Congenital Heart Center, University of Florida, Gainesville, Florida; Cardiac Kids Foundation of Florida, St Petersburg, Florida; Department of Cardiac Surgery, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
Background:
The purpose of this analysis was to review our 19-year experience (2006-2024) of a pediatric cardiac surgery volunteer program in Jamaica and to examine the transition of surgical responsibility to the local team, case complexity, and Operative Mortality.
Methods:
This was a retrospective study with a prospectively maintained database. Data points included diagnosis, procedure, surgeon, assistant, patient age, weight, sex, postoperative complications, and Operative Mortality.
Results:
A total of 142 index pediatric cardiac operations were performed on 137 patients. The mean age was 5.2 years (SD ± 5.1 years), with a range from 0 days to 16.9 years. The mean patient weight was 17.5 kg (SD ± 14.6 kg), with a range of 2.2 to 62 kg; 47.7% (n = 52) of patients were male and 52.3% (n = 57) were female. Operative complexity varied during the course of the 14 mission trips. There was a 5-year pause in mission trips (2018-2022), largely due to COVID-19. During the course of 13 operative mission trips in 18 years (2007-2024), the primary surgeon transitioned from the visiting surgeon to the local surgeon. In 2007 and 2008, 100% of cases were performed by visiting surgeons, whereas in 2024, only 33% of cases were performed by the visiting surgeons; 5.6% (n = 8/142) of patients had postoperative mediastinal reexplorations, with 1 patient having 2 reexplorations. Operative Mortality was 5 of 142 (3.5%).
Conclusions:
A 19-year collaboration between the local Jamaican team and the visiting team, based on partnership, teamwork, and sustainability, allowed gradual and safe transition of surgical leadership to the local Jamaican team.
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