UVM Larner College of Medicine Blog | Open Heart Surgery in Rwanda: Joining Team Heart

Written by Andrea Steely, M.D.’12

Growing up in southern California with two parents in the movie industry, I never imagined I would one day become a cardiac surgeon. I grew up drawing and painting—always being creative. In fact, I had planned to become an artist until science caught my interest in high school – I loved the idea of thinking up a question, doing some research, and coming up with a way to try and answer that question. It was not until the middle of high school that I ultimately began to seriously consider the idea of becoming a physician. Fast forward a few years later and I found myself interviewing for medical school.

I absolutely loved the Larner College of Medicine when I interviewed – it was exactly what I had been looking for—it was a small and friendly medical school where the students and faculty knew each other by name. While my four undergraduate years at UC Berkeley and one year of graduate work, culminating in a master’s in endocrinology, were great, I was really looking for a more intimate experience for medical school – one where I would find mentors who would encourage, inspire, and motivate me.

While at UVM, I found the mentors I had hoped for. I was lucky enough to match at UVM for general surgery residency and spent the first four and a half years gearing up for a career in vascular surgery. I was involved in both clinical and basic science research and presented my work at meetings around the country. But then, I scrubbed my first cardiac surgery case – a coronary artery bypass grafting – the bread and butter of cardiac surgery. I was mesmerized by every step of the operation – it was like a well-orchestrated dance. For the first time since starting residency, I thought that maybe vascular was not the path for me. After many conversations with mentors, friends, and family, I ultimately realized that cardiac surgery was exactly what I wanted to do – it was highly technical, efficient, rewarding, and challenging. And, moreover, my interest and dedication to the field of vascular surgery had prepared me to appreciate all of these aspects of cardiac surgery that were now so appealing.

My interest in cardiac surgery helped me to become involved in some incredible international work. I had the opportunity to work alongside and be mentored by Dr. Chip Bolman and Dr. Bruce Leavitt, also a UVM Larner College of Medicine alum from the Class of 1981 and now a cardiothoracic surgeon at UVM Medical Center. Dr. Bolman and his wife, Ceeya, started a non-profit organization called Team Heart, now 12 years ago, to help increase access to cardiac surgery in developing nations like Rwanda where rheumatic heart disease is rampant. Despite the high prevalence of cardiac disease, there are only a handful of cardiologists in the country and not a single cardiac surgeon. I had the opportunity to travel with this group, including Dr. Leavitt and Dr. Bolman, for their annual trip to Kigali as a general surgery resident in my final year of training in 2018. The experience was incredible and I found myself trying to find a way back. Dr. Leavitt helped me find a thoracic surgery foundation scholarship that supports the travel of cardiac surgery fellows and young attendings to international sites like King Faisal Hospital in Kigali, Rwanda.

I was lucky enough to win this award and had the opportunity to travel to Kigali again this past February. During the 12 days that I spent in Kigali, we reviewed 40 cases, paired down from the 100-plus that had been screened across the country the week prior, and selected just 16 patients for surgery. We operated on two patients each day for eight days in a row – weekends and weekdays – these were all surgery days. We brought our own pharmacists, intensivists, nurses, anesthesiologists, and perfusionists and gave these 16 patients a second chance at life. Most of our patients received a single heart valve replacement but about one-third of them had two valves replaced. Our patients ranged from 11 to 47 years old and were incredibly grateful for every aspect of their care.

Performing operations in a developing country is challenging, but doing open heart surgery in this setting, with no resources other than what we’ve brought, is incredible – it’s amazing what a group of people with a shared mission can accomplish. While it is the routine and methodical nature of cardiac surgery that allowed us to be so successful in Rwanda, participating in trips like this, which are hardly routine, reminds me of why I wanted to go to medical school in the first place – to make a difference in the lives of my patients in a unique way.

I am now finishing up my first of two years of cardiothoracic surgery fellowship at Beth Israel Deaconness Medical Center in Boston, Massachusetts. I remain mesmerized with cardiac surgery and cannot imagine doing anything else. I feel incredibly fortunate and privileged to do the job I get to do everyday. I am excited about the next phase of my career and I feel nothing but gratitude to have taken the path that I did because it got me to exactly where I am today.