Ramdeen Sanjhai L, Little Sherard G H, Forrester Sharonne, Patterson Cleopatra, Morris Tamra Tomlinson, Cooper David S, Vener David F, Justice Lindsey B, Redmer Wendy E, Hoag Katie, Lucas Kayla V, Walker Douglas J, McDonald Donna E, Hewitt LeeAnn, Sukumar Sarah, Carapellucci Jennifer, John J Blaine, Scholl Frank G, Badhwar Vinay, Edwards Melanie A, Jacobs Jeffrey Phillip
Departments 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.
Bustamante Hospital for Children, Kingston, Jamaica, West Indies.
Ann Thorac Surg. 2025 Jul;120(1):157-166. doi: 10.1016/j.athoracsur.2025.03.030. Epub 2025 Apr 4.
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.
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.
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%).
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.
本分析的目的是回顾我们在牙买加开展儿科心脏手术志愿者项目19年（2006 - 2024年）的经验，并考察手术责任向当地团队的过渡、病例复杂性和手术死亡率。
这是一项基于前瞻性维护数据库的回顾性研究。数据点包括诊断、手术、外科医生、助手、患者年龄、体重、性别、术后并发症和手术死亡率。
共对137例患者进行了142例初次儿科心脏手术。平均年龄为5.2岁（标准差±5.1岁），范围从0天至16.9岁。患者平均体重为17.5千克（标准差±14.6千克），范围为2.2至62千克；47.7%（n = 52）的患者为男性，52.3%（n = 57）为女性。在14次任务行程中，手术复杂性有所不同。任务行程有5年中断（2018 - 2022年），主要原因是新冠疫情。在18年（2007 - 2024年）的13次手术任务行程中，主刀医生从来访外科医生过渡到了当地外科医生。2007年和2008年，100%的病例由来访外科医生完成，而在2024年，只有33%的病例由来访外科医生完成；5.6%（n = 8/142）的患者术后进行了纵隔再次探查，其中1例患者进行了2次再次探查。手术死亡率为142例中的5例（3.5%）。
牙买加当地团队与来访团队基于伙伴关系、团队合作和可持续性进行的19年合作，使手术领导权得以逐步且安全地过渡到牙买加当地团队。
