Colombian surgeon is the first woman to implant an artificial heart in Latin America
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Sara Mendoza Crespo is a physician, general and cardiovascular surgeon, prepared at the Universidad Javeriana. She also completed a fellowship in pediatric cardiothoracic surgery at UPMC Children's Hospital of Pittsburgh.
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The procedure performed on an 11-year-old girl. Who was diagnosed at seven months of age with viral myocarditis, a condition that dilates the heart and reduce its ability to pump the blood normally. Her health deteriorated over time, and she was referred to FCV from Medellín.
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The FCV is a Latin American leader in this field: it has implanted 26 artificial hearts in adult and pediatric patients.
Bucaramanga, July 2022. After a semester of studying architecture, Sara Mendoza Crespo decided that her creativity would flow better in a surgery room than in a design workshop. She was not wrong. Today, 24 years after she graduated from medicine, she is making history by being the first woman to implant an artificial heart in Latin America.
This device, technically known as HeartMate III, is an alternative for hearts that can not pump blood throughout the body. It is used when heart failure is not controllable by medications, and the possibility of a transplant is not possible at the moment.
About 100 of these devices have been implanted in Latin America, most of those in adults and a small percentage in pediatric patients. It is the case of Sofía González Valencia, an 11-year-old girl who was operated on by Dr. Sara Mendoza, head of pediatric cardiovascular and congenital surgery at the FCV, and a multidisciplinary team from the Santander institution.
"It was a huge challenge because the device is designed mostly for adults and has a standard size that must fit in the girl's chest. It is a situation that is not easy to control because it is not clear how much space we have", assures Dr. Mendoza.
The surgery focuses on the left ventricle, where the device is implanted to assume the function of pumping oxygenated blood into the aorta and subsequently throughout the body. "The HeartMate III contains a rotor that magnetically levitates and has the capacity to pump up to 10 liters of blood per minute. It performs this task without generating heat or friction, protecting the blood cells," explains Dr. Leonardo Salazar Rojas, director of the ECMO and Artificial Heart program at the FCV.
Previous implant surgeries of other ventricular assist devices were a great help to Dr. Sara. Besides her experience, she added the study of literature on the subject and conversations with world experts in this technique. "I summarized some things about the process and broke it down into fractions. Then I said, I have done this, but at some point I have doubts, I need to review to undertake this challenge," she recalls.
In the middle of the preparation, there was a meeting with Sofia. They wanted to determine the best exit location for the power source, a cable routed from the device and goes through the abdominal wall to connect to an external mini-computer (the size of a cell phone) that controls the machine's activity. But the main goal, Dr. Sara says, was to find peace of mind together. "I wanted to know her, tell her what we were going to do, and feel that she accepted that I would be her surgeon."
The surgery performed on June 13, and after seven hours of work, the result was very satisfactory. "A procedure of this type can only be done with the support of a great team. It was a team achievement, involving instrumentalists, anesthesiologists, perfusionists, all the nursing management, our specialist Dr. Salazar, the accompaniment of surgeon Diana Fajardo and Dr. Holger Buchholz, from Abbott, the manufacturer of the device, among other people," says the specialist.
After the surgery, Dr. Sara was surprised by the good and rapid clinical evolution of the patient and the news of being the first woman to implant a device of this type in Latin America. "I never thought I would be the first when I performed the surgery. I did it because it was necessary. I did not expect it, but I am happy because the gap between men and women in the surgical sector is decreasing significantly", says the head of pediatric cardiovascular and congenital surgery at the FCV.
Sofia's condition and evolution
At seven months old, Sofia Gonzalez Valencia was diagnosed with viral myocarditis, a condition that dilates the heart and reduce its ability to pump the blood normally. With medication, she remained stable until October 2021, when she began to feel severe stomach pains and fatigue when doing any activity.
Due to her condition, in May 2022, the tests showed that she could not be a candidate for a heart transplant at this time, and the best option was the implantation of an artificial heart.
"In children, ventricular assist is used as a transition to a transplant in the future. For now, she must be recovered, learn to handle the device, and surely in two years or more she would be a candidate for the transplant", indicates Dr. Sara Mendoza.
The FCV medical complex, a Latin American leader in artificial heart implants
The FCV was the first Latin American institution to implant an artificial heart. The event occurred in 2014, and the patient, Cielo González, who was 51 years old, continues to enjoy her family today.
By performing Sofia's surgery, the hospital has performed 26 procedures of this magnitude: four of those on children. The survival rate of these patients, 12 months after the surgical procedure, is over 90%. Thanks to the excellent results. In 2019, the FCV received recognition as a center of excellence in ventricular assistance by the Joint Commission International, the most prestigious health accreditation organization worldwide.
