Sanjhai L Ramdeen, Sherard G H Little, Sharonne Forrester, Cleopatra Patterson, Tamra Tomlinson Morris, David S Cooper, David F Vener, Lindsey B Justice, Wendy E Redmer, Katie Hoag, Kayla V Lucas, Douglas J Walker, Donna E McDonald, LeeAnn Hewitt, Sarah Sukumar, Jennifer Carapellucci, J Blaine John, Frank G Scholl, Vinay Badhwar, Melanie A Edwards, Jeffrey Phillip Jacobs
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.