The 1st Inaugural UGMC PAEDIATRIC CARDIAC COLLABORATIVE PROJECT with HEARTS and MINDS of GHANA/BOSTON CHILDREN’S HOSPITAL

Partnership Projects of Children’s Lifeline™ – September 15-22, 2023

PERSONNEL

• Dr. Francis Fynn-Thompson – Pediatric Cardiac Surgeon/Clinical Lead – Boston Children’s Hospital; Hearts & Minds of Ghana
• Dr Baffoe Gyan-Consultant Cardiothoracic Surgeon/Head of Cardiovascular Surgery-UGMC
• Dr Gordon Offei-Larbi – Consultant Cardiothoracic Surgeon – UGMC
• Professor Nana-Akyaa Yao- Pediatric Cardiologist – UGMC
• Professor Frank Edwin, Pediatric Cardiothoracic Surgeon – UGMC
• Beverly Small – Senior Pediatric Cardiac Nurse-BCH Team
• Christine Placidi – Senior Pediatric Cardiac Nurse-BCH Team
• Lordina Yaokumah – DDNS Cardiothoracic Department
• Boston Children’s Hospital Team Members: – consultant pediatric cardiologist, senior pediatric cardiac nurses, pediatric cardiac perfusionists, pediatric cardiac anesthetists, pediatric cardiac intensivists, pediatric cardiac pharmacist, pediatric respiratory therapist, and IT technicians.
• Medical Officers and Pediatric Cardiac Medical Officer-Cardiothoracic Ward UGMC
• Cardiothoracic Ward Nurses UGMC

ACTIVITIES

Friday, 15th September 2023:
Ten patients with known cardiac diagnoses were admitted to the cardiac ward and had preparatory surgical blood investigations taken and processed. This was to avoid any delays in the processing of investigations should they be selected for surgery. The families were made to understand by written communication before admission that admission was not a guarantee that they would be chosen for surgery. The final decision for surgery was a team decision and would happen after repeat clinical evaluation by the Boston Team and in-house pediatric cardiologist and the team meeting on Saturday afternoon.

Saturday, 16th September 2023:
Ten patients underwent a detailed clinical evaluation. The team members in the relevant sub-specialties unpacked consumables and equipment and prepared the various clinical areas – theatre, intensive care, HDU. Team meeting involving all members to discuss and select suitable candidates for surgery, as this was a first-time project, was to select relatively low-risk cases.

Sunday, 17th September – Thursday, 21st September:
Two open heart cases were performed each day with Professor Fynn-Thompson as the lead surgeon on eight cases, and Dr. Gyan on two cases.

Friday, 22nd September:
The UGMC team performed an open-heart case independently with oversight and supervision from the Boston Team.

SURGERIES PERFORMED
A total of 11 cases were performed: all the children were over 10kg weight. There was a case mix of seven cases of Tetralogy of Fallot, two cases of Atrial Septal Defect, one case of Ventricular Septal Defect, and one case of a double-chambered high ventricle.

POST-OPERATIVE ACTIVITIES
All the patients except one were extubated in less than four hours in the intensive care unit. The one patient was extubated within 12 hours post-surgery. All patients spent no more than two nights in the ICU, two nights in the HDU, and one night in the ward.

DISCHARGE
Patients, on average, went home on day four post-op. The last two patients went home on Monday, 26th September 2023.

Future Directives

To ensure there is ongoing exposure and training. To have a debriefing meeting and have a specific strategy and plan for pediatric cardiac services: outpatient services, inpatient services, open heart surgeries, cardiac catheterization, training, audit, and research for 2024 and beyond. This will require the recruitment of the relevant team members for pediatric cardiac care since the workforce is currently not available. The Boston team hopes to come back in 2024 – details to be discussed.

---

Summary

We had a very successful mission trip to the University of Ghana Medical Center in September. We operated on 11 children, all of whom did exceptionally well, and we also were able to assess the strengths and weaknesses of the local team and environment. Overall, my team was very impressed and excited about the future potential.

As always, we and our local partners in Ghana  remain very grateful for the support of CLI. I am also putting together a specialty driven report of the potential for ongoing collaboration and support for UGMC.

Best,

Francis Fynn-Thompson, MD
Pediatric Cardiothoracic Surgeon
Department of Cardiac Surgery
Boston Children’s Hospital