Ready to Go Home: Heart patients from the island of Kiritimati prepare to return home after successful heart surgery at Baylor Scott White Heart Hospital in Plano, Texas. Second from left at top is team coordinator and nurse, Amy Moore. Third from right in back row is Dr. John Tekenane, chaperone and physician from the island.

PIMA Team to Establish Island Rheumatic Heart Disease Clinic

Following the return home of six more islanders from Kiribati having received life-saving heart surgery in Plano, Texas, the heart team returns this month to Christmas Island to set up a Rheumatic Heart Disease Clinic in conjunction with the Kiribati Ministry of Health to follow up on patients and review new cases.

Dr. David Moore, MD

Dr. David Moore, MD

“More than 45 Kiribati islanders all together have been saved with heart surgery provided free of charge by the team, led by Dr. David Moore, MD , cardiothoracic surgeon from Cardiac Surgery Specialists in Plano, Texas and Baylor Scott White Heart Hospital there … and his incredible team,” said Carlton Smith, president of Pacific Islands Medical Aid, Inc.

“What is needed now is a program to monitor all patients who have returned to their home islands, and to establish a way to identify new cases,” Carlton said.

The team is scheduled to depart toward month’s end and will remain on Christmas Island for one week to help get the program going, Carlton said. Joining Dr. Moore will be Dr. Kelley Hutcheson, MD, cardiothoracic surgeon, echo specialist Jessica Gilbert and social services director Sherry Swanson, both from Baylor Scott White Heart Hospital in Plano.

Dr. Moore said that he and his team “are looking forward to working with the medical personnel on Christmas Island, under the direction of medical officer in charge Dr. Teraira Bangao, to establish a more robust program for rheumatic heart disease patients.”

Here is Dr. Moore’s story:
By Dr. David Moore, MD

Rheumatic Heart Disease (RHD) remains a worldwide health issue with prevalence in the remote islands of central and western Pacific.

In May of 2018, a medical team from the Baylor Scott and White Heart Hospital in Plano, Texas travelled to Kiritimati (Christmas Island) to conduct echo screening and evaluate patients with suspected RHD.

A group of patients were identified with severe mitral, aortic and tricuspid valve disease. Several patients with symptoms of coronary artery disease were also noted.

In October, nine patients, accompanied by local island physician Dr. John Tekanene traveled to Baylor Scott White for further evaluation and surgery.

Five patients received open heart surgery for valve repair or replacement and one patient underwent coronary bypass surgery. All patients recovered well and returned home safely.

The medical team from Plano will return to Kiritimati later this month to work with local medical personnel in establishing an RHD clinic on the island. This clinic will carefully follow patients who have had valve surgery, managing medications and anticoagulation.

Patients with a history of rheumatic fever will be treated with prophylactic penicillin injections, and echo screening done for patients with heart murmurs and symptoms consistent with RHD. A data base of RHD patients will be established and patients seen at regular intervals for medical management.

Patients identified with severe RHD will be evaluated carefully for heart surgery and appropriate patients brought to Baylor Scott White Heart Hospital in Plano for operation.

The support of the Kiribati Ministry of Health, Baylor Scott White Heart Hospital in Plano, Texas, and Pacific Islands Medical Aid, (PIMA) is greatly appreciated as this work continues.