Cleimar: Hearts Without Borders
Cleimar’s parents learned that their second child had a severe heart defect just 22 days after her birth on Sept. 8, 2006. Her darkened skin and heart palpitations led to a referral to Lourdes Trujillo, M.D., a cardiologist in their hometown of Caracas, Venezuela.
After a series of tests, Dr. Trujillo met with the infant’s parents, Jesus and Betzabeth, and delivered a complicated diagnosis of complete atrioventricular canal defect, Tetralogy of Fallot, pulmonary atresia and patent ductus arteriosus. Venezuelan cardiovascular surgeons deemed Cleimar’s case inoperable.
Meanwhile in Houston, pediatric cardiovascular surgeon William I. Douglas, M.D., learned of the case through the International Services Center at Memorial Hermann-Texas Medical Center. The Center welcomes patients from more than 70 countries each year. They come seeking initial diagnosis, treatment for a diagnosed disease or disorder, a valued second opinion or an annual checkup.
Caseworkers also facilitate referrals through international charity programs that send patients abroad when treatment is unavailable at home. One such program is run by the Venezuelan state-owned petroleum company, Petróleos de Venezuela S.A. (PDVSA), known as Citgo in the United States.
Cleimar qualified for the PDVSA program and – with the help of her personal International Services Center liaison, Patricia Colmenero – arrived in Houston in late October for her first appointment with pediatric cardiologist Gurur Biliciler-Denktas, M.D., FAAP, FACC who is affiliated with the Children’s Heart Institute at Children’s Memorial Hermann Hospital and an assistant professor of pediatric cardiology at The University of Texas Medical School at Houston (UT Medical School).
By the time Cleimar was scheduled for surgery on Nov. 7, 2007, she was just older than 1 year. Working with his partner Felix Tsai, M.D., Dr. Douglas partitioned the right and left side of her heart using a large patch made from her own pericardium.
“Her aorta extended over the usual division between right and left sides of the heart, so we needed to create a partitioning patch to compensate for the defect,” said Dr. Douglas, who is also affiliated with the Children’s Heart Institute and an associate professor in the department of Cardiac Surgery at UT Medical School.
In a four-hour procedure, the surgeons used a cadaver graft to create a pathway from the right side of her heart to her lungs. After a seven-day hospitalization, the tiny patient was released to the care of her parents.
“She’s doing well, and her long-term prognosis is good,” Dr. Douglas said. “We were able to do a complete repair. The cadaver tube between her right heart and lungs will have to be changed approximately every 10 years.”
Cleimar is one of three recent patients from Venezuela treated at Children’s Memorial Hermann Hospital, two of which were declared inoperable in the South American country.
“With three complex cases from Venezuela with good outcomes, I’m hoping we can generate some momentum in our international referrals,” Dr. Douglas said. “There’s so much we can do to help worldwide, but if you’re from the United States, it just makes sense to work with countries in Latin America.”
Dr. Douglas credits the International Services Center for its help in making the lifesaving surgery possible.
“They connected us, and they provided help for Cleimar’s family to smooth out the care process,” he added. “They arranged for housing for her parents and got them to and from the hospital. They also provided translation services for the physicians. It took an enormous effort on the part of a lot of people to make Cleimar’s surgery possible. We’re all happy she’s doing well.”
For their part, Cleimar’s family is thankful for the help their daughter has received from its American neighbor to the north. “The attention was excellent across the board – from her doctors and nurses, from the International Services Center and from the entire hospital staff. We are very grateful,” said Jesus.