Fixing Heart Valves in Africa.

For years now we have been seeing young patients in many countries who are suffering the long term effects of Rheumatic heart disease. If discovered early, treatment can prevent the progression.

This is why we have been teaching the rapid Echocardioloy screening method (Mentioned in a previous blog post). For those who already have advanced destruction of their valve, the only hope is to fix the valve or replace it with an artificial valve. As you can imagine, valve replacement is rarely available and very expensive when it can be done. It also requires the patient to commit to lifelong blood thinning and frequent expensive testing.

A few years ago we went to Nepal to learn a procedure where we could fix the valve without surgery. By passing a catheter to the heart and puncturing a hole across from the right side to the left atrium, we can put a balloon through the valve, inflate it and open the valve (which has been stuck closed with scar from the rheumatic fever). As far as we could tell, this has never been done outside of an expensive cardiac catheterization lab.

With much prayer, we did our first cases in February of 2014 at Tenwek Hospital in Kenya. We were able to do 14 cases with good results using only C-arm fluoroscopy instead of having a cath lab. Dr Rajib from Nepal came to Kenya to assist us. Last year we were able to fix 12 more hearts.

Pascal always wanted to be able to play football (soccer) with his friends, now he can! 

With this procedure patients are able to be discharged to home he next day and are not required to be on blood thinning medication. Our goal is to teach this procedure to local staff so that eventually no child from sub-Sahara Africa will be more than one border away from this life saving procedure.

Rheumatic Heart Disease Screening

Rheumatic Heart Disease (RHD) is an inflammatory disease of heart valves that is common in the developing world. The repeated bouts of inflammation of heart valves from a particular type of Step infection causes the valves to deform resulting in leaking or failure to open normally. For over 25 years we have seen so many children and adolescence have their lives cut short by this disease. It effects girls more than boys and many times results in death of the young mother during childbirth. The additionally sad issue is that this is a preventable disease. Much of our efforts through Lifesteam are directed toward helping these young people through sponsoring heart surgery, teaching physicians overseas to medically manage this heart disease optimally, and training in prevention of progression of RHD.

Lifesteam has encouraged, helped equip with ultrasound machines, and trained physicians in Cameroon, Democratic Republic of the Congo, Kenya, and Tanzania to screen school age children at no cost for early signs of RHD. Once early evidence of RHD is found on a brief cardiac ultrasound examination, the child can be placed on penicillin to prevent progression of the disease. Teaching echocardiology in Kenya We can screen hundreds of children at schools and churches throughout Africa where an average 3-4% have the beginnings of RHD. The goal is to screen tens of thousands and impact this devastating disease with prevention rather than expensive medications and surgery later in the course of the disease.  Lifestream is committed to providing training, assisting with the purchase of ultrasound equipment, and  penicillin needed for the children identified at risk for this devastating  heart disease. 

Adokorach's Heart

ADOKORACH, a 22 year old mother of a 1 year old boy began noticing difficulty keeping up with the other young women her age 3 years ago. Her heart condition made the pregnancy and childbirth difficult and dangerous. Adokorach lives in northeastern Congo near a mission hospital where we've taught general cardiology including cardiac ultrasound.

Ultrasound images of her heart sent to us revealed that Adokorach had severe mitral stenosis (a narrowing of one of the heart valves from scarring after her episodes of acute rheumatic fever). The valve should open up as large as a soda bottle cap to let blood through, but hers only opened to the size of a drinking straw.

More troubling, she had developed blood clots in her heart behind the valve narrowing which put her at risk of having a stroke at this young age. With her in mind, we brought a new lab machine out to Congo which would enable them to put her on anticoagulation and closely monitor her levels of blood thinning. The medication has dissolved the blood clots that were in her heart. She is now on them continuously until we can get her to Kenya to fix her valve.

Adokorach having her blood checked.

Training staff to use the new INR machine to monitor anticoagulation in patients in Congo.