{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:16:28Z","timestamp":1787019388098,"version":"build-2736575974"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This report documents the outcomes of cardiac surgical mission trips organized by the International Children's Heart Foundation (ICHF), a nongovernmental organization that provides congenital heart surgery services to the developing world, and discusses factors associated with a reduction of mortality and morbidity in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of a prospectively maintained database was conducted to identify any patient who underwent surgical intervention during the course of an ICHF mission trip.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From 2008 to 2016, a total of 223 trips were made to 23 countries and 3,783 operations were performed. Over 40 unique types of operations were performed with repairs of atrial septal defects (ASDs; n = 479), ventricular septal defects (VSDs; n = 760), teratology of Fallot (n = 473), and ligation of patient ductus arteriosus (PDA; n = 242), comprising the majority of cases. Several organizational policy changes were instituted in 2015. These include the requirement of the host site to have a fully functional blood bank and access to medical subspecialties, the ICHF providing 24-hour intensivist coverage, and not performing surgery on patients weighing less than 10 kg until local capacity has been developed. The overall mortality rate fell to 2.3% from 8.1% after the implementation of these policies. The mortality for ASD repair, VSD repair, PDA ligation, and the repair of tetralogy of Fallot fell from 1.2% to 0%, 1.8% to 0%, 0% to 0%, and 5.6% to 5.1%, respectively. The reoperation rate fell from 11% to 3% and reoperation for a bleeding indication fell from 6% to 2%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Programmatic-level changes have been associated with reduced rates of mortality and morbidity in humanitarian congenital cardiac surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2150135117737686","type":"journal-article","created":{"date-parts":[[2018,1,8]],"date-time":"2018-01-08T23:22:55Z","timestamp":1515453775000},"page":"47-53","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Programmatic Changes to Reduce Mortality and Morbidity in Humanitarian Congenital Cardiac Surgery"],"prefix":"10.1177","volume":"9","author":[{"given":"Tyler J.","family":"Wallen","sequence":"first","affiliation":[{"name":"Department of Surgery, Mercy Catholic Medical Center, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George J.","family":"Arnaoutakis","sequence":"additional","affiliation":[{"name":"The University of Florida Health System, Gainesville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa","family":"Blenden","sequence":"additional","affiliation":[{"name":"The International Children\u2019s Heart Foundation, Memphis, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Soto","sequence":"additional","affiliation":[{"name":"The International Children\u2019s Heart Foundation, Memphis, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,1,8]]},"reference":[{"key":"bibr1-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01886-7"},{"key":"bibr2-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-308173"},{"key":"bibr3-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.09.013"},{"key":"bibr4-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-014-2559-2"},{"key":"bibr5-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.02.006"},{"issue":"3","key":"bibr6-2150135117737686","doi-asserted-by":"crossref","first-page":"VII","DOI":"10.1590\/S0102-76382009000400003","volume":"24","author":"Maluf MA","year":"2009","journal-title":"Rev Bras Cir Cardiovasc"},{"key":"bibr7-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)03228-3"},{"key":"bibr8-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.025"},{"key":"bibr9-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1586\/erc.09.141"},{"key":"bibr10-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1053\/j.pcsu.2010.02.001"},{"key":"bibr11-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.03.062"},{"key":"bibr12-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2002.119064"},{"issue":"8","key":"bibr13-2150135117737686","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s00246-009-9496-0","volume":"30","author":"Jacobs JP","year":"2009","journal-title":"Pediatr Cardiol"},{"key":"bibr14-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.01.057"},{"key":"bibr15-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu469"},{"key":"bibr16-2150135117737686","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2010.00479.x"}],"container-title":["World Journal for Pediatric and Congenital Heart Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2150135117737686","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2150135117737686","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2150135117737686","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:21:08Z","timestamp":1777591268000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2150135117737686"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1177\/2150135117737686"],"URL":"https:\/\/doi.org\/10.1177\/2150135117737686","relation":{},"ISSN":["2150-1351","2150-136X"],"issn-type":[{"value":"2150-1351","type":"print"},{"value":"2150-136X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1]]}}}