03:43am Sunday 24 September 2017

IMI’s Global Connections Help Heart Patients

But when Fox needed treatment for aortic stenosis, she looked to South America when she wasn’t eligible for the corrective heart valve trials being done in the United States. To accomplish this, Fox turned to the Miller School’s International Medicine Institute (IMI), which in 2008 helped establish South America’s first certified program for minimally invasive valve replacement in Cali, Colombia. The IMI arranged Fox’s week-long hospital stay in Cali, where she underwent the CoreValve replacement, a procedure not yet available in the United States.

“My mother had reached a point when she didn’t want to travel any more but she didn’t want open-heart surgery and she tried but wasn’t accepted for more experimental and less invasive treatments in the U.S.,” said Judy Fox, Selma’s daughter. “We had some initial concerns about going to Colombia for medical care, but we had exhausted all our options at home.”

The Foxes also were comforted by the University of Miami connection to the Colombia program, and the IMI staff’s compassion and attention to every detail. “The International Medicine Institute took care of the travel arrangements and everything else we needed,” Judy Fox said. “We really had nothing to worry about.”

Helping patients like Fox who need assistance navigating language and logistics of international health care is only one segment of the IMI, one of the most prolific arms pushing the University’s global efforts in patient care and education.

In patient care, the IMI has made big strides and is largely responsible for the increase in international patients who seek care at University of Miami Health System – UHealth hospitals and clinics. Through strong networking efforts and the high quality of the UM brand, patients in the Caribbean, South and Central America and as far away as Europe and the Middle East have been flying to Miami for UHealth care and cutting-edge treatment.

“We have really worked hard to establish IMI as a premier place for medical care for international patients,” said Eduardo de Marchena, M.D., a cardiologist who is associate dean of international medicine and chair of University of Miami Medical Group. “Our vision is global and that explains our extensive partnerships, including us helping establish the first certified minimally invasive valve replacement program in South America in 2008.”

In South America, de Marchena worked with noted interventional cardiologist Antonio Dager, M.D., a graduate of the Miller School’s William J. Harrington Medical Training Programs for Latin America and the Caribbean, to establish “the skills and facility expertise to perform these wonderful new procedures.” Recently, another Harrington Program alumnus, Panama City interventional cardiologist Norberto Calzada, M.D., became the first to conduct a CoreValve procedure in Central America.

In Selma Fox’s case, after she decided not to undergo open-heart surgery, she sought out UM because of its reputation for high quality care, and because it was one of only a few sites where a new cutting-edge percutaneous aortic valve replacement surgery was being done in clinical trials.

But while at University of Miami Hospital, under the care of Pedro Martinez-Clark, M.D., assistant professor of medicine, a battery of tests indicated that Fox was not a good candidate for the valve program offered to certain elderly patients deemed high-risk or non-operable for conventional open-heart surgery. Fox also made an attempt to have the procedure done in Canada, but that also fell through.

So, at age 93, Fox traveled to Cali, one of a handful of places around the world that does CoreValve transcatheter aortic valve implantation, another new minimally invasive procedure, where catheters are used in the replacement of the stenotic aortic valve.

In Cali, the CoreValve procedure is offered at Angiografia de Occidente, a hospital affiliated with UHealth through the IMI. As part of the affiliation, UM doctors work side by side with Angiografia de Occidente staff.

“I feel much better than before,” said Selma Fox, who acknowledges that once in a while her blood pressure will rise. “What the doctors did was amazing. I felt no pain and the care was wonderful from lovely people. As a patient, I couldn’t have asked for more.”

Similar outcomes and expressions of thanks also have come from patients like Isaac Hariton, M.D., and Janet Pease. Hariton, 86, a Venezuelan surgeon who recently moved to Aventura, and Pease, 74, of Fort Myers, both underwent CoreValve procedures.

“Being a surgeon, my father was able to review and compare the data, which he did, and decided to go to Colombia,” said Paul Hariton. “The initial nervousness we felt went away when we saw the facilities and the staff.”

“As a doctor, I can honestly say I received some of the best care I have ever seen here in Miami and in Cali,” the elder Hariton said. “It was well worth it. I feel great.”


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