An Israeli pediatric cardiologist flew to Rwanda to assist in an emergency procedure on an 11-day-old baby with a rare and life-threatening heart defect, returning to Israel shortly after the operation was completed.
Dr. Sagi Assa, head of the Interventional Pediatric Cardiology Unit at Wolfson Medical Center, traveled to Kigali on behalf of Save a Child’s Heart (SACH) after being contacted by Dr. Gerard Misago, a Rwandan pediatric cardiologist whom he had trained in Israel.
The patient, a baby boy named Angel, was born with critical pulmonary valve stenosis, a congenital defect that severely restricts blood flow from the heart to the lungs and requires urgent treatment.
Angel, the firstborn of twins to a young couple from a rural area of Rwanda, was taken through four regional hospitals before reaching King Faisal Hospital in Kigali. By the time he arrived, doctors said he was in critical condition.
Dr. Misago contacted Assa because of the risks involved in performing the procedure on a newborn weighing just 2.6 kilograms (5.7 pounds). “Because it is a high-risk procedure with significant mortality, we felt we should perform it together in Rwanda for the first time,” Dr. Assa said.
He left Tel Aviv shortly after midnight, flew through Addis Ababa and arrived in Kigali at 10 a.m.
The doctors performed a balloon pulmonary valvuloplasty, a catheter-based procedure used to widen the narrowed valve without open-heart surgery. The operation required threading a catheter through blood vessels only a few millimeters wide and into the chambers of the baby’s heart. A misplaced guidewire could have perforated the heart.
Dr. Sagi Assa with Dr. Gerard Misago, Dr. Christine Niyibogora and other members of the cardiac team at King Faisal Hospital in Rwanda
(Photo: Courtesy of SACH)
Dr. Misago led the procedure with support from Dr. Assa and Dr. Christine Niyibogora, a local pediatric cardiac anesthesiologist who was also trained in Israel through the Save a Child’s Heart fellowship program.
The team successfully widened Angel’s pulmonary valve. Within hours, the baby was stabilized in intensive care, removed from ventilation and reunited with his mother for feeding.
Dr. Assa left Rwanda shortly afterward, completing the trip in less than 30 hours. The procedure came only months after Dr. Misago returned to Rwanda following a three-year fellowship in Israel. "This was the culmination of three years of training and partnership. Seeing Dr. Gerard and his team perform so exceptionally under high pressure proves that Rwanda now has the local capability and confidence to treat complex heart conditions independently," Said Dr. Assa.
Dr. Sagi Assa en route to Kigali, Rwanda
(Photo: Courtesy of SACH)
“A mentor’s job is to make you independent, not to keep you reliant,” Dr. Assa added. “I decided to be there to support him, but he was the one leading.”
The operation also marked a step toward allowing more children with congenital heart defects to receive treatment in Rwanda rather than being sent abroad.
Simon Fisher, executive director of Save a Child’s Heart, said the procedure represented an important milestone for the pediatric cardiology program at King Faisal Hospital. "This joint operation marks a key milestone in the independent pediatric cardiology program in Kigali, ensuring that children across Rwanda born with congenital heart defects can receive world-class medical care in their home country."
Until recently, a newborn in Angel’s condition would probably have required emergency evacuation for treatment abroad, if such treatment could be arranged in time.
Save a Child’s Heart (SACH), founded in 1995, has treated more than 8,500 children from 75 countries and trained hundreds of medical professionals in pediatric cardiac care.