{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:39:05Z","timestamp":1762101545738},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,4,14]],"date-time":"2014-04-14T00:00:00Z","timestamp":1397433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,4,14]],"date-time":"2014-04-14T00:00:00Z","timestamp":1397433600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/100000895","name":"St. Jude Medical Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000895","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Importance<\/jats:title><jats:p>Rheumatic heart disease (RHD) in the developing world results in critical disability among children, adolescents, and young adults\u2014marginalizing a key population at its peak age of productivity. Few regions in sub\u2010Saharan Africa have independently created an effective strategy to detect and treat streptococcal infection and mitigate its progression to RHD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>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\u2019s current capacity to address screening and primary prevention, as well as provide life\u2010saving cardiac surgery for patients with critical RHD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence review<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>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\u2010day mortality). Postoperative complications included a cerebrovascular accident (<jats:italic>n<\/jats:italic> = 1) and hemorrhage, requiring reoperation (<jats:italic>n<\/jats:italic> = 2). All procedures were performed with participation of local personnel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and relevance<\/jats:title><jats:p>This strategy provides a reliable and consistent model of sophisticated specialty care delivery; inclusive of patient\u2010centered cardiac surgery, mentorship, didactics, skill transfer, and investment in a sustainable cardiac program to address critical RHD in sub\u2010Saharan Africa.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2559-2","type":"journal-article","created":{"date-parts":[[2014,4,13]],"date-time":"2014-04-13T19:00:29Z","timestamp":1397415629000},"page":"2205-2211","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Partnership for Sustainability in Cardiac Surgery to Address Critical Rheumatic Heart Disease in Sub\u2010Saharan Africa: The Experience from Rwanda"],"prefix":"10.1002","volume":"38","author":[{"given":"JaBaris D.","family":"Swain","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Cardiac Surgery Brigham and Women\u2019s Hospital\u2010Harvard Medical School Boston MA USA"},{"name":"Team Heart, Inc. Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel N.","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiac Surgery Brigham and Women\u2019s Hospital\u2010Harvard Medical School Boston MA USA"},{"name":"Team Heart, Inc. Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Mucumbitsi","sequence":"additional","affiliation":[{"name":"Rwanda Heart Foundation Kigali Rwanda"},{"name":"King Faisal Hospital Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel K.","family":"Rusingiza","sequence":"additional","affiliation":[{"name":"Rwanda Heart Foundation Kigali Rwanda"},{"name":"Kigali University Teaching Hospital (CHUK) Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Ruhamya","sequence":"additional","affiliation":[{"name":"Rwanda Heart Foundation Kigali Rwanda"},{"name":"King Faisal Hospital Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abel","family":"Kagame","sequence":"additional","affiliation":[{"name":"Rwanda Heart Foundation Kigali Rwanda"},{"name":"Kigali University Teaching Hospital (CHUK) Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gapira","family":"Ganza","sequence":"additional","affiliation":[{"name":"Rwanda Heart Foundation Kigali Rwanda"},{"name":"Kanombe Military Hospital Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia C.","family":"Come","sequence":"additional","affiliation":[{"name":"Team Heart, Inc. Boston MA USA"},{"name":"Harvard Vanguard Medical Associates Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suellen","family":"Breakey","sequence":"additional","affiliation":[{"name":"Team Heart, Inc. Boston MA USA"},{"name":"Massachusetts General Hospital Institute of Health Professions Charlestown MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonnie","family":"Greenwood","sequence":"additional","affiliation":[{"name":"Team Heart, Inc. Boston MA USA"},{"name":"Department of Pharmacy Brigham and Women\u2019s Hospital\u2010Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen D.","family":"Muehlschlegel","sequence":"additional","affiliation":[{"name":"Team Heart, Inc. Boston MA USA"},{"name":"Department of Anesthesiology, Perioperative and Pain Medicine Brigham and Women\u2019s Hospital\u2010Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Patton\u2010Bolman","sequence":"additional","affiliation":[{"name":"Team Heart, Inc. Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"Binagwaho","sequence":"additional","affiliation":[{"name":"Rwanda Ministry of Health Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Morton Bolman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiac Surgery Brigham and Women\u2019s Hospital\u2010Harvard Medical School Boston MA USA"},{"name":"Team Heart, Inc. Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,4,14]]},"reference":[{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2009.10.002"},{"key":"e_1_2_14_3_2","volume-title":"Disease control priorities in developing countries","author":"Gaziano TA","year":"2006"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135111425394"},{"key":"e_1_2_14_5_2","first-page":"643","article-title":"Rheumatic fever and rheumatic heart disease: the last 50 years","volume":"137","author":"Kumar RK","year":"2013","journal-title":"Indian J Med Res"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.114199"},{"key":"e_1_2_14_7_2","volume-title":"Rheumatic fever and rheumatic heart disease report of a WHO expert consultation","author":"World Health Organization","year":"2004"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa065085"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.836510"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(05)70267\u2010X"},{"key":"e_1_2_14_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp078039"},{"key":"e_1_2_14_12_2","first-page":"367","article-title":"The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease","volume":"3","author":"Seckeler MD","year":"2011","journal-title":"Clin Epidemiol"},{"key":"e_1_2_14_13_2","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.2002.1062"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.153.7.681"},{"issue":"3","key":"e_1_2_14_15_2","first-page":"229","article-title":"A proposal for the eradication of rheumatic fever in our lifetime","volume":"96","author":"Bongani MM","year":"2006","journal-title":"SAMJ"},{"key":"e_1_2_14_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.000032"},{"key":"e_1_2_14_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/021849230601400422"},{"key":"e_1_2_14_18_2","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA\u20102012\u2010013"},{"key":"e_1_2_14_19_2","volume-title":"The PIH guide to chronic care integration for endemic non\u2010communicable diseases","author":"Bukhman G","year":"2011"},{"key":"e_1_2_14_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(08)60962\u20109"},{"key":"e_1_2_14_21_2","unstructured":"MucumbitsiJ et al (2013)Prevalence of rheumatic heart disease: screening of school age children in Gasabo district: phase I. PASCAR Abstract Program"},{"key":"e_1_2_14_22_2","doi-asserted-by":"publisher","DOI":"10.4103\/1755\u20106783.43071"},{"key":"e_1_2_14_23_2","first-page":"301","article-title":"The development of cardiac surgery in an emerging country","volume":"353","author":"Velebit B","year":"2008","journal-title":"Tex Heart Inst J"},{"key":"e_1_2_14_24_2","doi-asserted-by":"crossref","unstructured":"JonasRA(2008) Congenital heart surgery in developing countries.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. doi:10.1053\/j.pcsu.2007.12.001","DOI":"10.1053\/j.pcsu.2007.12.001"},{"key":"e_1_2_14_25_2","doi-asserted-by":"publisher","DOI":"10.1586\/erc.09.141"},{"key":"e_1_2_14_26_2","first-page":"61","article-title":"The cost of open heart surgery in Nigeria","volume":"14","author":"Falase B","year":"2013","journal-title":"Pan Afr Med J"},{"key":"e_1_2_14_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2010.02.019"},{"key":"e_1_2_14_28_2","volume-title":"Working toward transformational health partnerships in low\u2010 and middle\u2010income countries","author":"Little M","year":"2012"},{"key":"e_1_2_14_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2007.02.017"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-014-2559-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-014-2559-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-014-2559-2","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T19:35:42Z","timestamp":1703619342000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-014-2559-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,14]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1007\/s00268-014-2559-2"],"URL":"https:\/\/doi.org\/10.1007\/s00268-014-2559-2","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,14]]}}}