Riley International Heart Missions

February 2020 Riley/Rotary VTT Mission to Amman with partners Chain of Hope and GOLA – Jordan trip #30-3rd post (days 5 & 6)

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Today we awoke to another sunny and breezy day, and the night was uneventful. Our patients are doing well and we plan to extubate Ibrahim and Karam today. Mahmoud will remain intubated but is stable on nitric oxide (for pulmonary hypertension). We will slowly wean this and start an oral pulmonary hypertension medicine. Perhaps extubation tomorrow. Abdulluh did great overnight and likely will transfer out to the floor today.

Sahed giving us a bit of a smile

Abdullah before his transfer to the floor

Heather with Ibrahim after extubation

Dr. Jana listening to Abdullah

Our first case today was Ahmed Aloush. A small 11 month old male with tetralogy of Fallot. He has a restrictive VSD with right to left shunting, a diated right ventricle with diminished function, and very small right and left branch pulmonary arteries – 2 to 3 mm diameter. So instead of a complete repair Dr. Mark placed a right ventricular outflow patch and made the hole between the upper chambers a little larger. He did well and was extubated shortly after arriving to the ICU.

Ahmed before surgery

The second case was Yasmin Alfadel. A beautiful 3 year old girl with a very large secundum ASD. The defect measured nearly 2 cm. At home we might have closed this with a catheter device which is not available here. But part of the rim of tissue around this defect was deficient, and so she very likely would have needed a surgical closure as well. This went smoothly, and we anticipate early extubation as well.

Yasmin, also before surgery

We finally got to our hotel in time to clean up and get ready for the Annual Gift of Life Amman Gala. It was a beautiful affair and we had a great time celebrating the wonderful work and fund raising achieved by everyone gathered. Although the next morning we felt a little more tired than usual.

It was another good night for Dr. Ghadi and Dr. Kamal. Our patients were stable and progressed well in their recovery. Yasmin is quite anxious and unhappy this morning, but well enough to transfer to the floor.

Dr. Ghadi and Dr. Kamal with Karam

Karam making big strides each day

Today, day 6, we began with an unplanned add-on. Amalayman Alnaj is a 6 day old female who was born with an interrupted aortic arch and large VSD. She travelled to Amman from Iraq and has been on prostaglandin (a life saving IV medicine needed until surgical repair) until it ran out about 12 hours before we saw her. We admitted her from Dr. Khal’s office and got the prostaglandin restarted again. Dr. Mark repaired the aortic arch abnormality from the left side of the chest and placed a pulmonary artery band. She did very well and will recover in the ICU.

Our final patient of the mission is Youssef Mousa who is an 8 month old male with a complex form of Tetralogy of Fallot. His left pulmonary artery was quite small and came off the ascending aorta. This was re-implanted (unifocalized) to the main pulmonary artery. Dr. Mark will plan to complete the repair at future mission after this artery has grown.

The end of the mission photo

Across the board, we are a truly tired but rewarded group. In all we performed 12 operations on 11 children, including 7 Syrians, 3 Jordanians, and one Yemeni. In addition, Dr. Khal performed Cardiac catheterizations on 4 patients, including 1 each from Yemen, Iraq, Jordan and Syria. Three of these involved interventions such as a balloon valvotomy, PDA device closure and collateral embolization. Altogether a very busy mission with perhaps the highest number of complex cases and infants Dr. Turrentine can remember on one trip.

Not mentioned in my posts has been the amazing generosity and support of GOLA, GOLI, and Chain of Hope. Feeding us at the hospital, taking us to dinner or hosting us in their homes. Thank-you Emma and Oroyo (Chain of Hope). Thanks as always for your support to our team and efforts Rob Raylman (President of GOL International). Thank-you Dr. Khal for always being there, planning transportation, sharing in the planning and care of each patient, and bringing great energy and joy to all that we are doing. To Nael (who is at the end of his current term as president of GOLA) and Ruba – your efforts and friendship are irreplaceable. And to all our friends in Amman – all of what we do is simply not possible without you.

Until next time, Amman

In memory of Seilina Sema who we lost after a valiant effort following her heart surgery

Written by tcordes757

March 5, 2020 at 7:39 pm

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February 2020 Riley/Rotary VTT Mission to Amman with partners Chain of Hope and GOLA – Jordan trip #30-2nd post (days 3 & 4)

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This has continued to be a busy mission. Our patients have been complex and our days and nights quite busy. Early Monday morning part of the team drove into the hospital to help Dr. Jana and Dr. Ghadi (Critical Care fellow from AUB) who had several patients developing difficulty at the same time including Seilina who had a brief cardiac arrest and resuscutation. Karam also was having sustained runs of SVT with low blood pressure. And Ibrahim, who was tenuous after his rough day. Fortunately things were settling down as we arrived. Some changes in our plans and a few limited to echoes to be sure there were no surgical issues to address, and things returned to a more stable state.

One of our first day patients, Aldalrahman, was doing great although his face didn’t clearly show it.

The first case of the day – Monday, (day 3) – was supposed to be a 5 month old with a PDA ligation. But when we did a transthoracic echo before the case started we discovered that the PDA had spontaneously closed. So no need for surgery. Therefore… we moved the second case up. Shahed Hamden is an 18 year old female who had previous repair of a sub-aortic double outlet right ventricle. She later had a second operation for sub-aortic and sub-pulmonary stenosis. She is here for a replacement of her pulmonary valve. She is a sweet young woman who did well and was awake and spelling “thank-you” in the air before she was extubated.

Shahed before her pulmonary valve replacement

We ended the day with closure of Ibrahim’s sternum. We were still dealing with challenges from Seilina throughout the day which finally seemed to improve once we were able to start nitric oxide for pulmonary hypertension. Karam was still having non-sustained SVT but tolerating this better, although also having some bradycardia and frequent extra beats despite being on 2 anti-arrhythmia medications.

Dr. Ghadi is our primary night ICU doctor in house with alternating backup from Dr. Jana and Dr. Kamal. And our CVICU nurses alternate being available to come in as needed at night. This has proven to be both necessary and helpful, as our doctors and nurses have needed to be quite active in the ICU through parts of this night again. But today was a bright and beautiful day, and we are hoping our patients settle out, and our cases progress successfully.

I forgot to mention that yesterday Abdalrahman was moved out of the ICU, and today we plan to transfer Shahed to the floor because she is doing so well.

Morning rounds with the ICU team

One of the challenges this trip is a frequent change in the schedule which, when it happens, is for the safety of our patients. Today was the same when our first planned patient developed a concerning cough and wheezing. We quickly checked the other patients in the hospital who were waiting for their operation, and who had not eaten yet.

And so we began with Mahmoud Alkhoulani. He is a 10 month old male with a history of previous diaphragmatic hernia and repair of this. His heart disease includes a large muscular VSD, large ASD, large PDA and failure to thrive. Basically 3 large connections in his heart that likely initially led to too much blood flow to his lungs that hurt his growth, and then eventually led to high blood pressure in his lungs. All of these were closed today, except for a small residual VSD that is not that unusual in the location where his was.

Mahmoud before his operation this morning. The definition of a penetrating gaze.

Emily and Dr. Kevin starting the case with Mahmoud

Our second case today was Abdullah Obaji, who is a handsome 13 year old male with a history of previous repair of tetralogy of Fallot and now significant stenosis in the area below his pulmonary valve and leak of the pulmonary valve. He had enlargement of the sub-pulmonary narrowing and replacement of the pulmonary valve. The operation went well, and we anticipate a good recovery.

Abdullah looking relaxed the morning of his surgery

In the OR with Abdullah

Written by tcordes757

March 3, 2020 at 9:56 pm

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February 2020 Riley/Rotary VTT Mission to Amman with partners Chain of Hope and GOLA – Jordan trip #30-1st post (days 1 & 2)

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Our team has come together over several days with most arriving on Thursday 2/27/20  after a delayed and rerouted journey that took over 28 hours.  Dr. Turrentine, Dr. Abulebda, Dr. Assy (American University of Beirut) and Dr. Cordes had the pleasure to present at the 15th Annual Middle Eastern Pediatric Conference with other guest faculty including many from Riley. And then, on Saturday, 2/29 our 30th mission began.

Most of our team – From left to right: Dr. Mark Turrentine (Congenital Heart Surgeon – Team Leader), Dr. Jana Assy (AUB Pediatric Cardiac Critical Care), Dr. Tim Cordes (Peds Cardiologist), Brittany Mote (OR Nurse), Dr. Kevin Graham (CT Surgery Resident), Mike Horner (Perfusionist), Heather Dornbusch (peds CVICU Nurse), Emily Sauders (OR Nurse), Sheila Rochio (Peds CVICU Nurse), Dr. Kamal Abulebda (Peds CV Critial Care)
The traditional first group photo at the hospital as the mission gets underway.

As the title above mentions, this is the 30th Mission Trip to Amman Jordan – over 14 years.  It is an incredible milestone and achievement made possible by the many supporters we have. Gift of Life International and Gift of Life Amman, Rotary Club of Greenfield, Chain of Hope – London, the many team members from Riley, Indiana, and now American University of Beruit, and many additional friends and family at home and here in Jordan.  We jumped from the Dr. Khal Salaymeh’s conference right into our cases for this trip.  I have been slow to begin this blog because we truly hit the ground running – as always.  I have barely had time or opportunity to dust off my camera but will try to do better.  As I write this, we have completed 4 cases over the first 2 days, and I only have photos from the OR.

Here is what we have done so far:

On Saturday we operated on Seilina Amer Al Semadi – a 4 month old girl with Down Syndrome and AV Canal Defect.  Her right upper chamber was on the small size, which added to the challenge of the case. Her lungs were also quite congested.  The operation ultimately went well, but she was a challenge over night  in terms of ventilation and BP.  She was better today and will slowly be weaned off oh her heart medicines and ventilator support.

Top: Mike Horner running perfusion during our first case. Bottom: Dr. Mark and Dr. Kevin with Seilina.

Seilina – post-op

Our second case Saturday was Abdalrahman Nabil Ahmed Al-Abarah – a 2 year old boy with acyanotic (pink) Tetralogy of Fallot.  He only needed a VSD patch closure as his pulmonary valve was normal.  But he did have pulmonary hypertension.  With the help of pulmonary hypertension medicine, he was extubated this morning and is doing well.

Top: Emily and Brittany helping with Abdalrahman.  Bottom: Dr. Kevin and Dr. Mark operating on Abdalrahman.  I know it looks similar to the first case picture but there aresubtle differences.

After an amazing dinner with our GOLA hosts at an Armenian Fusion Restaurant, we rested on very full stomachs to start the day today.  This began with Karam Anas Rabe’a Sheleh – a 3 month old baby boy who Dr. Mark operated on 6 weeks ago doing a BT shunt and PA band.  This was to help the left ventricular get stronger before today’s PA band takedwon, BT shunt division and Arterial Switch operation.  This is a big operation in any event but this patient also had slightly abnormal coronary arteries that added to the difficulty level.  The post-bypass transesophageal echo showed a great repair, and Karem is now recovering in the ICU.  He will remain on the ventilator overnight, but hopefully will come off this suport tomorrow.

OR Team with Karam

The second case was Ibrahim Ali Altemer – a 1 month old with very complex single ventricle heart defect.  His heart defect belongs to a diagnosis group called heterotaxy and among many other defects he had pulmonary valve atresia.  He has been waiting for surgery on a special medicine called prostaglandin to keep blood going to his lungs. The plan today was to try to make his atrial septal defect bigger without going on bypass, and place a central shunt.  During the case he proved to be very fragile, but both goals were accomplished.  He will need quite a bit of support to recover, and will need to go back to the OR this week to closed his sternum.

(I didn’t have my camera with me for our 4th case)

Our team has been outstanding in the face of the hard work needed for each of these patients.  Starting in the OR and followed by Sheila, Heather and Dr. Kamal and Dr. Jana along side our local nurses and therapists in the OR & ICU have brought all their skill and experience to bear to help these beautiful children get better.

I will send more (especially non-OR pictures) in the next posts.

Written by tcordes757

March 1, 2020 at 10:15 pm

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November 2019 Riley/Rotary Vocational Training Team Trip to Amman with partners Chain of Hope and GOLA- The Wael Karadsheh Mission!- Final Farewells for this Mission.

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By Friday morning, many of the team and Oroyo would be moving on to home or other destinations. Dr. Riad and Melissa and Dr. Mark and I made rounds in the morning on the kids. Many of the children would move out to the floor from the ICU. Melissa and Dr. Riad departed for some touring on their own for a couple of days. Hayam needed a pacemaker placed, so that was done in the OR by Dr. Mark. There is a good chance that her normal rhythm might come back with some time. She will follow up with cardiology in her home country of Yemen. Aseel remains on the ventilator, but her numbers are looking better and will likely be extubated on Saturday.

Don’t have photos of everyone, but had to snap a few of the cute name signs that the staff made for the kids’ beds…



A closer one of Hasan that Ruba caught with a sly little smile!

Abdel Rahan only 1 day Post-op.

And of course another of our sweet Niemah!

It was a crazy busy 4 days of work in Amman. Eleven cases of this complexity might be a full month’s worth of work for a surgeon at some hospitals… The team worked so hard this week and leave exhausted but satisfied that much good work was done and many from all over the world contribute and partner up to make it all possible… We are so thankful! ❤️

We are so thankful especially to Dr. Khaled Salaymeh who will continue to care for these kids in the hospital, then most as outpatients thereafter. He will keep us updated on the children as will Ruba and GOLA.

As the sun sets on beautiful Jordan and on this Wael Karadsheh mission, we look forward to the next Riley Team trip to Amman made possible by a Rotary Foundation Global Grant, scheduled for early March 2020… “Inshallah!”

Beautiful sunset over the Dead Sea Friday. Good-bye for now, Amman!

Written by stephkinnaman

November 30, 2019 at 2:49 pm

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November 2019 Riley/Rotary Vocational Training Team Trip to Amman with partners Chain of Hope and GOLA- The Wael Karadsheh Mission!- Operating Day 4!

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Dr. Kal took the team out for Falafel, hummus, and Syrian ice cream last night for dinner and they were able to have an earlier night back to the hotel. I stole these great photos of the crew from Dr. Anne:

Today is our Thanksgiving in the US… It is a day that we celebrate with family over turkey and other traditional foods and give thanks for the many blessing we have. We are so thankful to be here in Amman today. Because of the talent and generosity of the Riley team, they are able to be a blessing to these families who need hope. There is no greater way to give thanks! ❤️ I am thankful to witness such great humanity in this team and so many of those who have donated their time and financing of this mission and the 27 others before! Thankful you you all! ❤️❤️

We start this Thanksgiving with rounds in the ICU. I failed to notice until last night that Monday we operated the 500th patient for this Riley Team and Gift of Life Indiana!! Niemah, the Coarc from Monday is that special patient for this milestone!!

Our November 2019 mission team with Gift of Life Indiana’s 500th patient, Niemah!

Miriam (VSD, POD #3) is looking fantastic, taking a bottle during rounds, and waved to me across the room! She is a doll! She will be moved to the floor today to make room for our patients operated today.


Hassan (VSD, POD #3) is looking so much better today! Awake and alert.


Niemah (our 500th patient, as mentioned above!) is doing great as well. She is the Coarc who is POD #3. Alert and bright-eyed and she looked so much like she would smile at Oroyo this morning as he told her how brave and strong she is! So very sweet!

Oroyo and Niemah

Niemah even worked up a smile for Melissa and Dr. Stephanie! (Smile not seen here, take my word for it!)

Patrick got some Niemah time also! 😊

Hussein (POD #2, TOF) is looking great as well! He loves to cross his legs like a grown man, but also chew on the leg of his frog.


Hayam (POD #2 large PDA and VSD) is awake and off the vent today and so so cute… She might need a pacemaker placed before we leave. It is early postop, but she is still needing paced by the temporary pacemaker and we hate to leave without taking the next step if needed.


Qasem (POD #1, Rastelli) is looking fantastic. He doesn’t think the same of our team as we rounded!


Oroyo even tried to cheer him up with his goody bag from Riley:

Qasem and Oroyo. He’s still not thrilled with our group… 🙂

Aseel (POD #1, PA band) might come off the vent today. She had a little fever last night and still having some low heart rate, which will likely improve with some time.

Rounds this morning on Aseel

Abdel Rahman (POD #1, PDA ligation at 5 1/2 mos old) is being extubated today. He is doing well.

We have 8 operative cases completed so far this week and Dr. Kal did a cath as well Monday, so we have 9 patients completed this week and 2 more today.

Abdel Rahim is a 15 year old handsome boy from here in Jordan. He has a sinus venosus ASD and has apparently had shortness of breath for some time.

Abdel Rahim

His repair went very well… Dr. Anne once again scrubbed out from assisting to do the TEE and then scrubbed back in to help finish the case.

Post-repair TEE by Dr. Anne

In the meantime, apparently Qasem finally checked out the toys and was quite excited about them! They definitely got a smile out of him upstairs!


The next case today was tiny Muhiar. He is a 3 week old slightly preterm (36 weeks) baby from Syria. He was born by c-section for some fetal distress and admitted to NICU for respiratory distress and low oxygen sats. They found he has pulmonary atresia and a large PDA. His little heart is essentially working as a single ventricle… He will need staged surgeries to correct his anomalies. Today we did a Blalock shunt and located the PDA. He will still need future surgeries, but this is a good start. This is not a surgery on bypass, so we were done in the OR by 2:30.

Muhiar in the ICU just after surgery with Dr. Riad.

In the meantime in the ICU, Dr. Anne did echos on everyone. Dr. Riad and Melissa had extubated Abdel Rahman, the PDA from yesterday, and he has been a fussy boy all day since then. They were still in the room when his roommate Aseel, the PA band, decided to plug up her ET tube and her heart rate and blood pressure dropped. They worked on her for less than a minute and decided she may do best without the tube. Interestingly, that little “code” corrected her heart rate (had been a 2:1 block since surgery) and she looks amazing! We told her to share some of her calm nature with her fussy roommate Abdel Rahman!


Abdel Rahman, momentarily resting his eyes between fussing… momentarily!

Baby Muhiar had a rough start in his postop. The whole team was in the room and working to correct his acidosis and BP issues for a several hours… Aseel too decided to put up a little excitement again soon after this. She will be relegated to a quiet, dark room for less excitement!

Both little ones were quite a lot of work for the Riley and Al Khalidi teams so far this evening. Aseel was eventually reintubated after a third spell of low sats and bradycardia. She was stabilized after this on the vent. Her pulmonary hypertension is likely to blame and she will stay on the vent overnight and watched closely.

Rima has been such an amazing help this week in translating for the families and comforting the mothers of the mission. Thank you, Rima!

Rima, Nick, and Neimah!

Baby Muhiar has complicated medical problems. He might have a syndrome of some sort… His heart disease as noted above was so complex as to require IV prostaglandins to keep the 1.) PDA open indefinitely, 2.)send the parents home with a baby that will not survive, or 3.) do something to try to give him a chance- as we did today. He is struggling postoperatively tonight because of the severity of his heart disease.

Ruba and Na’el have a Thanksgiving dinner planned for the team. We look forward to celebrating the many successes of the week and have much for which to give Thanks. We will certainly have Muhiar and his sweet parents on our minds as we do so, but Dr. Riad will be quite literally there all evening as we eat turkey and appreciate our friendships…. Many prayers going out for these patients and their families! ❤️

Written by stephkinnaman

November 28, 2019 at 11:04 pm

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November 2019 Riley/Rotary Vocational Training Team Trip to Amman with partners Chain of Hope and GOLA- The Wael Karadsheh Mission!- Operating Day 3

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Another wonderful night of fellowship with Rotarians and GOLA members remembering a wonderful man. We gathered around the very table where the original GOLA members- Sirene Shamerza, Wael Karadsheh, Marikay Satryano and others sat to conceptualize their organization. His wife, Najwa insisted on making dinner herself (she is an amazing cook!!) and inviting us to celebrate the life of this great man who was truly larger than life- in his personality and in his big heart! We so enjoyed the evening!

Our group at Wael and Najwa’s house last evening

This morning, we gathered for breakfast after the McKay family (Anne’s family) set off for some Amman tours. The Lindbloms and Megan as well as Nick and Rima joined us to see the patients this morning. Josh and Aurielle really enjoyed meeting the patients and families today… It was so touching to see the amazing connection between the Lindbloms and the families here despite the language difference (Rima translated for them). They truly understand what it is like to sit waiting for their child to return from surgery, to recover from surgery, to see the wonderful transition after surgery- their 3yr old daughter, Monroe, has had surgery by Dr. Turrentine twice for her heart defect. They shared pictures of Monroe with the families and explained that the same surgeon and the same team operated on their child as well! Priceless! ❤️

Josh and Aurielle Lindblom with Aseel (our upcoming 3rd surgery today)

The Lindbloms with Aseel and her mother, Nick, Dr. Riad, and Rima

Josh Lindblom sharing recent pictures with Miriam’s mother of their daughter Monroe, whose last heart surgery by Dr. T was 1 year ago!

Megan, Josh, and Aurielle came in for one last look in the OR before they left for some touring as well. It is their first trip to the Middle East and their first big look “behind the scenes”Hopefully they enjoyed it as much as we enjoyed having them! Safe travels, Josh, Aurielle, and Megan!

The children in the ICU are doing well… Miriam (VSD, POD #2) looks fantastic, but no kisses blown at us today on rounds!

Miriam and Melissa

Hassan (VSD POD #2) is doing well also. He has some pulmonary hypertension that will likely improve with time.

The Lindbloms with Hassan’s parents and his nurse.

Niemah (Coarc, POD #2) looks like a different baby! She is alert and her eyes look bright and she is always hungry!Dr. Riad, Dr. Anne, Dr. Kal, Dr. Markwith Niemah


Niemah’s echo by Dr. Kal looks great, Dr. Anne agreed!

Hussein, (Tetralogy of Fallot, POD #1) is doing fantastic! He is so pink! Dr. Riad found out some more great info about him and his family yesterday… He is from Najaf or Najaf al Ashraf( Iraq), a city central south Iraq and one of the holiest cities in the Islamic world. He has been symptomatic for a while with cyanotic spells and developmental delay. He is here with his dad and grandmother (just cleared up yesterday finally! We were confused that his father was his brother yesterday! Now we know it is his father and grandmother!) Extended family including mom are waiting for him in Iraq. He has an older sister. He does not talk or walk yet but his sister was delayed in these at one time as well. They are hoping he will catch up faster after heart surgery! He extubated only one hour after surgery last night and was eating and drinking the same night after the operation! Most notably, Dr. Riad and Melissa were able to “meet” (via FaceTime) the matriarch of the family, his 115 year old great great grandma (maybe not enough “great”s?!). She was expressing her amazement and gratefulness for this blessing for their family! What a special moment!!

Hussein’s grandma in the background as they FaceTime the 115 yr old matriarch of their family!

Also Hayam is POD #1 large VSD repair and large PDA ligation. Hayam will be 1 on December 3rd this year. She is the only child for her parents who live in Aden (Yemen), a beautiful port city and the temporary capital of Yemen. Dad was not able to travel with mom to Jordan but they are both excited about Hayam’s surgery offered by Chain of Hope! She remains intubated the morning after the surgery to help with her expected pulmonary hypertension and some LV dysfunction. She is still paced at this time as well with a temporary pacemaker.

Hayam before her surgery

This morning, we started with a lively little guy with quite a complex heart… Qasem was a live wire last night when the team first met him! Qasem is a 3 1/2 yr old boy from Baghdad, Iraq. He has a VSD, PDA, and Pulmonary atresia. He already had a shunt placed in India about 2 years ago. He started developing shortness of breath and increasing cyanosis again about 5 months ago. Chain of Hope was called and arranged for his travel here to Amman for treatment by our team.

Qasem with Dr. Riad and Melissa last night

Qasem (thanks to Oroyo from COH for the awesome photo!)

Qasem’s CTA- the circled area shows the very narrowed left pulmonary artery

Qasem’s surgery is a “redo”, so scar tissue and old sternotomy wires, and figuring out another surgeon’s work makes it more time-consuming and complicated. However, his Rastelli procedure in the end makes surgeries complete for this little guy. Even this very tired surgery “assistant” says the repair was beautiful!!

Aseel was the second patient of the day… quite the sweet little one. She is a Syrian patient of only 15 days old and needs a PA band as a start to correct her issues… She has sats in the 80’s with her hypoplastic left heart syndrome. Dr. Kal was consulted from another hospital’s NICU. She will need more surgeries, but this will help to relieve some of the overload of blood flow to the lungs through the pulmonary arteries. The surgery went quite quickly and successfully


The third case of the day quickly follows Aseel’s! They were ready right away in another OR for Dr. Mark and Dr. Anne… a PDA ligation of 5 1/2 month old Abdel Rahman Abdel. Abdel is from Damascus, Syria and has been persistently short of breath since about 2 months of age “after bronchitis” his medical record says… He was found to have a patent PDA. This too is a quick surgery not on bypass. Dr. Anne and Dr. Mark quickly and efficiently complete that case and the OR time is done for the day about 4:30.

Abdel Rahman

Ruba and I could be found (or not! 😉) between cases, between the ORs blogging and posting about the missions to our respective organizations- GOL Indiana and Rotary and for Ruba, GOLA! (The behind-the-scenes stuff!)

Ruba (GOLA) and Stephanie (GOL Indiana, Rotary Club of Greenfield)

A HUGE shout-out to the amazing Hani!! Hani is the perfusionist who has worked with Dr. Mark all these years, but he also coordinates the patches needed, equipment needed, notifying the OR of planned cases, etc. He is amazing and we could not do it without him! Thank you Hani!

Hani, our awesome perfusionist and OR coordinator!

The OR cases seem to be set for tomorrow, so we will settle in the patients for tonight and hope to get back to the hotel for a little dinner and a little more rest tonight!

But first, Dr. T must finish some notes… and have some cheesecake that Ruba brought for his big birthday! Yes, he is spending his birthday doing what he loves best- operating on children in need in Amman! Happy birthday to the amazing, talented, and generous Dr. Mark Turrentine!!

Written by stephkinnaman

November 27, 2019 at 5:56 pm

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November 2019 Riley/Rotary Vocational Training Team Trip to Amman with partners Chain of Hope and GOLA- The Wael Karadsheh Mission!- Operating Day 2

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We had a wonderful dinner last night with Rotarians and GOLA members at Majdoline! It was amazing Arabic food and great fellowship… and a late night!

Dr. Mark awoke with little to no voice and an advancing cold, it seems… We planned to have to keep even more quiet than he usually likes his OR!

Dr. Mark and his many cups of tea with honey! All special delivered and made with care when they heard his voice this morning!

Many of our special visitors set off to Petra then the Dead Sea this morning. Nick and Rima and Patrick remain with the team. Also, Oroyo arrived last night from London for Chain of Hope! So happy to have Oroyo with us this week after their amazing fundraiser Gala last weekend! It’s been a busy time for him!We set off together to the hospital after breakfast to first see the children from yesterday. They are doing very well in the unit. Dr. Riad got some great photos and some more information about the patients and family from yesterday…

Miriam is a 10 month old from the city of Palmyra, Dr. Riad says is “one of the oldest cities on the planet”. She has 3 siblings- 8, 6, and 3 and all are healthy. The family has been living in a camp in Jordan for the last 3 years. She has Trisomy 21 and had a large VSD. Miriam had no weight gain in the last 2-3 months, had a consistent cough for the last 3 months, and increased work of breathing. Dad is staying with the children while mom is here with Miriam. She is doing great today and even blowing kisses to our team!

Miriam blowing kisses… I hope this video works! She’s so sweet!

Nick with sweet Miriam!

Hassan is a 7 month old from Idlib, Syria. He has 3 siblings. He has had poor weight gain and increased shortness of breath in the last 3 months. He was extubated this afternoon after this photo and is doing great!

Niemah, the tiny Aortic Coarctation baby from yesterday is doing fantastic today. We were told this morning at pre-rounds looking at chest X-rays that she was “hungry” by Rami, the Head ICU nurse. She is 4 months old, but the size of a newborn (4kg, about 8lbs 13 oz!). Her family moved to Jordan from Syria 7 years ago. They had 2 other girls, but one passed away. At 2 months of age an echo was done because of her severe persistent cough. She was found to have the Coarctation, but her family could not afford the high cost of surgery, so had prepared themselves that they might lose another daughter. Look at her now! (Already!)

Our first case of the day today was Hussein from Najaf, Iraq. He came to Amman with his mother and father. He is an 8 month old sweetheart who knows how to smile when a phone is lifted up to him! 😉. He is adorable!

Hussein with his mother and father

Hussein has Tetralogy of Fallot and gets blue a lot with activity- crying, feeding, any type of “excitement”. He has a very narrow infundibulum… The case was challenging, but the pulmonary valve was spared and his sats were great after surgery. He was extubated right after surgery and doing well. Apparently there was a little excitement in the ICU later when his father came to see him in the ICU… He fainted right away and required a little medical treatment of his own. Likely all the excitement and emotion of the day caused this and he will be fine! Mr. Hussein will certainly grow and do so much better after this excellent repair!

Rima, Dr. Anne, and Dr. Mark talking to Hussein’s mother and father before surgery.

He is now in excellent hands with Dr. Riad and Melissa (they are a team in and out of the ICU…For the readers who don’t know- they are husband and wife!) Dr. Riad is originally from Syria, so his passion for this work is obvious every day… He is a huge help in making the families at ease by speaking their language and knowing their land and understanding much about their plight…

Between cases, an old patient came up to visit who Dr. Mark operated 5 years ago! Her father is a pharmacist here at Al Khalidi. Salma has grown so much, is in her 6th year of school and looks great! Dr. Anne was great to offer to check her echo while she visited. She is doing well!

Dr. T and Salma

In the meantime, Dr. Riad sent a picture of Miriam with the comment, “First patient to ask for CVL removal “… too cute not to share!

The OR called again ready for Dr. Mark and Dr. Anne for the second case. As they went down to prepare, Najwa and Randa, Wael Karadsheh’s wife and daughter came to visit. They were visibly moved by the children and mission honoring this great man and co-founder of GOLA. Randa came to visit in the OR as well! We look forward to visiting with them more at dinner tonight. They have graciously offered to host our team tonight.

Ruba and Randa

Randa at the head of the table, watching the work being done to save more children in her father’s name this week. (Thanks to Oroyo for the great photo!)

Our second case of the day is Halah from Yemen. Chain of Hope flew her and her family as well as Hussein’s to Amman for surgery by the team this mission. She is adorable. She came in over the weekend with a consistent cough, but maybe a fever as well… she has been afebrile for at least 2 days after treatment as an inpatient over the weekend. Her cough is likely from the large VSD (she also has a large PDA and pulmonary hypertension). She is only 15lbs at almost 1 year of age… Another tiny one!

Adorable Halah

Halah’s surgery went well. Dr. Rand second assisted on both surgeries today. She is a medical intern and also a Rotaract member. She was a challenging case due to her pulmonary hypertension and large VSD and PDA… She came up to the ICU on a little Milranone and paced for now.

Dr. Anne passes off the info from OR to Dr. Riad about Halah.

We made a round through the ICU to check on the patients. Neimah is looking fantastic! She was moved to a new room, down the hall from the others.


Hussein is obviously hungry… eating his makeshift gauze mittens and the wubby! Poor little guy! So pink though! His mother could tell the difference immediately!


After the trip through the ICU to consult with Dr. Riad and Melissa, we will now go to Dr. Kal’s office to discuss some outpatients and solidify the cases for tomorrow. We will then go to see Najwa and Randa and again remember the great man after whom this mission is named- Wael Karadsheh!

Written by stephkinnaman

November 26, 2019 at 4:24 pm

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November 2019 Riley/Rotary Vocational Training Team Trip to Amman with partners Chain of Hope and GOLA- The Wael Karadsheh Mission!

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Today starts the 28th Riley Team trip to Amman and we are excited to get started! We are honored to remember a great Gift of Life Amman friend who passed away since the last mission, a man with a huge heart for these little hearts, Wael Karadsheh.

Wael on the far left with GOLA friends Dr. Nawar, Dr. Anne, Sirene, Lamia, Rob Raylman CEO of GOL International, Dr.Stephanie, Dr. Mark, and Wael’s wife Najwa.

The team arrived in various stages Sunday and the Rotaract group from Amman-Jerash was so kind to assist in all the various waves of arrivals, taking team members and trunks from the airport to the hospital and eventually to our hotel. It was quite a late arrival for many, so the night was short, but we have so many children on the list this week to help!!

We have several special guests this week as well- the Lindblom family – Josh and Aurielle- from Indianapolis with friend from the IU Health Foundation, Megan. The Lindbloms have raised funds for the Heart Team’s International work and will be helping this mission as well. It will be wonderful for them to see the work they are helping to make possible first-hand! Also, Nick Shneker, nephew of Dr. Riad, raised funds for GOL Indiana in honor of his Uncle Riad and the amazing work he does for the team. Happy to have him see the work he is making possible as well! He plans to go to medical school in the future and perhaps follow in his uncle’s footsteps. His mother, Dr. Riad’s sister Rima traveled from Columbus, Ohio as well for the mission. Patrick McKay, Dr. Anne’s son (who came with her for the mission in March as well) is an experienced help to the others navigating the different areas we travel about in the hospital, Dr. Kal’s office, etc. He is a senior at IU also looking to a career in medicine. How awesome that so many are inspired by the missions… Inspired to help financially and inspired to do this work themselves someday!

The team this week includes:

Dr. Mark Turrentine, Surgeon

Dr. Anne Farrell, Cardiologist

Dr. Riad Lutfi, Intensive Care Specialist

Melissa Redden, ICU nurse and Nurse Practitioner

Dr. Stephanie Kinnaman, Family Physician and Rotarian Team Leader

We join so many wonderful professionals at Al Khalidi Medical Hospital once again to help more children who desperately need assistance with their congenital heart disease… Dr. Khaled Salaymeh, the amazing cardiologist here in Amman has once again screened and discussed these patients with GOLA and the list is about 20 patients long! We certainly cannot do all of those cases this week in our 4 operating days planned, but will do as many as possible.

Miriam was our first patient of the day. She is a Syrian refugee from a camp close to Amman. She is a small 10.5 month old girl with Down Syndrome who was discovered to have a loud murmur at birth that turned out to be a VSD. Dr. Mark closed that once on bypass in just 15 minutes, Dr. Anne said. (I’m sure it’s because he had such an excellent assistant! 😉😂🤣) and a GREAT audience!

The first case of the mission! Dr. Tariq on the right is a second assist and also a local Rotaract member!

All of our friends and extended “team” joined us in the OR. Unfortunately, the camera isn’t working to project the view from above the incision to see what we see at the OR table. So, the anesthesiologist was so accommodating to allow them to take turns to see from the head of the table. All went well and she was transferred to the ICU where Melissa and Dr. Riad took over with the Al Khalidi ICU team.

Dr. Riad and Melissa straight to work.

Our “extended team”.

Our wonderful GOLA friend Ruba interpreting for Dr. Mark to Miriam’s family after the surgery/before they see her in the ICU.

Much discussion in the short time between cases about at little girl Yasmeen from Jordan who has Tetralogy of Fallot and dextrocardia and a generous, hardworking woman Farrah who raised money for her heart surgery… However, she is only 2.5 months old, with pretty good sats, so will likely be operated on another mission in the future.

Farrah with baby Yasmeen and her mother.

Also much discussion about the 3rd case of the day planned, a tiny little baby Nemaih from Syria as well who lives in a nearby camp… She has coarctation of the aorta with very little Left ventricular contractility…. We want to ensure that her LV can recover/has some reserve, so while we were in the first case, they started some dopamine and Dr. Anne rechecked her echo thereafter and checked the gradient… a little more than before when the heart was barely pumping. We will try to help this tiny one as the third case today.


Our second case of the day is Hasan. Hasan is a 7 month old Syrian boy also with a perimembranous VSD. Al Khalidi was so kind to give us a second OR room so we could get started straight away. Dr. Anne scrubbed in for this case. She is most certainly the “jack of all trades” this mission, needed in every facet- teaching about the defects and surgical repair to our special guests, she echos, she blogs, she sees clinic patients with Dr. Kal, she warmly welcomes and puts at ease the patients and families. Yes, she does it all!

Megan, Josh, and Aurielle with Dr. Anne in the OR for the first case.

Dr. Anne assisting on the second case with Dr. Mark.

Hasan’s case went very well and he was transferred to the ICU where Melissa and Dr. Riad were ready to take over. He was settled in quite nicely in no time, but still Intubated for now.


Little Nemaih’s case was prepped fo follow quickly in a different OR, but she is so very tiny that the anesthesia team had trouble getting her lines started. With coarctation of the aorta, the blood pressures are lower in the legs than the arms, so although her arm blood pressure is rather high for her tiny frame and young age, her pulses are hard to find in the femoral area and therefore hard to cannulate an artery. Dr. Mark was summoned to do an arterial cut-down, and even that was tricky. They went on to prep for the case while we ran over to Dr. Kal’s office for a consultation on another outpatient. They were ready more quickly than we were done in his office, so off we rushed again!

Nemaih as mentioned above is 4 months old, but the weight of a newborn. So very tiny. The definition of “failing to thrive” due to her failing heart trying desperately to beat our more blood to the lower extremities that are not getting much with this tight constriction or “Coarctation”. Dr. Mark quickly identified the tiny, constructed area in the OR (not needing cardiac bypass for this case, and a side approach), resected, and repaired it. Will spare you the pictures for the medically faint and believe me when I say it was impressively narrowed. What an amazing thing to see as the clamp was removed that so quickly the lower and upper extremities blood pressure fully equalized! This baby Nemaih will THRIVE now! She will stay Intubated and on the ventilator overnight.

Our OR day is finished, but we still have OR notes to write, patients to check on for tomorrow’s cases. There will possibly be 3 cases again tomorrow… will see how they check out before we decide for sure! 😉The schedule is always a moving target, despite everyone’s best efforts!

We had a great day with all of our amazing donors seeing how their funds are put to work! Thank you Lindbloms!! Your generosity will go far in healing more children with congenital heart disease around the world! The children this week will certainly enjoy their little baseballs and baseball blankets, a nod to Josh’s baseball career (just named Korean Baseball Organization’s MVP TODAY).

Megan from IU Health Foundation (and long-time friend of the Lindbloms) and Aurielle Lindblom with Dr. T.

We also must thank Nick Shneker who contributed to our GOL Indiana program and will certainly go to the next mission grant! 🤗

Patrick, Josh, Nick, Dr. Anne, Aurielle, and Megan.

The Rotarians have planned a dinner for about 50(!!😳!!) tonight at a local restaurant for us at 8:30… We look forward to their amazing Arabic food and company! Much more to come this week! Stay tuned, friends! We love comments on the blog… especially as the days are long and the week becomes longer, we love your encouragement! Thanks for following! ❤️

Written by stephkinnaman

November 25, 2019 at 5:54 am

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August 2019 Riley/Rotary Vocational Training Team Trip to Amman with Chain of Hope, GOLA, and Veterans Rebuilding Life- Final Mission Day!

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Hawra, our 16 month old Kurdish boy had his operation today by Dr. Turrentine 2 days ago. The beautiful child is sponsored by a group called Veteran’s Restoring Lives. He was extubated after surgery but developed lung complications as a result of so much (now a normal amount) of blood flow going to his lungs. Because of his age and his low saturations his lungs have become accustomed to low blood flow and that was dramatically changed by surgery.  With some time on the ventilator his lungs improved and he was extubated this morning and we are confident he will be able to breath on his own now. 

Dr. Turrentine feeling relieved that Harwa has turned the corner.

Batoul moved to the floor and is doing great. She will have her chest tube removed and be discharged tomorrow. 

Sireen had another good night. She is definitely on the mend now. She is taking full nutrition now and should be moved to the floor tomorrow.

Mouhammad with Sireen.

Qasem had another great night. He is continuing to breast feed and we are decreasing breathing support steadily so he should move to the floor later today or tomorrow. 

Qasem headed down to the floor and out of the ICU!

Jouri is in great spirits most of the time but is still in intermittent heart block after her operation but it is improved and Dr. Bassam wants to wait another day before deciding whether to place a pacemaker. 

Mira will be discharged today. Terrific news for her as we were concerned at one point she might need a procedure to drain fluid from around her heart. 

Jana continues to cruise after surgery to fix the large hole between the bottom two chambers of her heart. She went to the floor yesterday and will be discharged tomorrow.

Jana getting a soccer ball after her chest tube came out. 

Mazin, Zainalabideen and Sewar will all be discharged today as well. Great to see so many kids on the mend and headed home before we wrap the mission and head back home.

The team with Mazen. 

Open heart surgery two days ago…now soccer in the hallway with the team. 

Sewar ready for discharge.

Abdel Qader needs one more day in the hospital before heading home tomorrow. 

Thanks to GOLA for the photo of Abdel Qader!

The team got to experience the Dead Sea Friday afternoon after morning rounds at the hospital. It was an incredible experience for 5 of us who have never been there before. 

We are refreshed and ready for the last case of the mission, Talia. She is 10 months old with Down syndrome, a PDA and large ASD with poor weight gain. The case was off a little late, but finished in the morning without complication. It is a holiday here and we are thankful the hospital staff is here to support the patients on this final day. 

Thanks again to GOLA for the OR pic including Dr. Johansen (who never included himself all week!) from Talia’s surgery.

Tomorrow we begin the long journey home after another successful and rewarding mission.  We are again grateful for the patients we serve, Dr. Kal for his friendship and collaboration, the hospital and hospital staff, Na’el and Ruba, all of GOLA, Chain of Hope, Veterans Restoring Lives, Rotary Clubs of Indiana and of Jordan, Rotary International, all of our amazing hosts, the city, and the region for making us feel so welcomed.

The entire staff at Al Khalidi has been tremendous. 

Until the next mission.  Insha Allah.

Written by stephkinnaman

August 31, 2019 at 7:58 pm

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August 2019 Riley/Rotary Vocational Training Team Trip to Amman with Chain of Hope, GOLA, and Veterans Rebuilding Life- Working Day 5 (Thursday)!

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Hawra, our 16 month old Kurdish boy had his operation today by Dr. Turrentine.  The child is sponsored by a group called Veteran’s Restoring Lives.  The diagnosis was uncertain when he arrived and, after a few tests, it became more clear that his operation would be a challenge. Performing his repair in multiple steps was considered but was ultimately decided that it could safely be performed in one operation. This was done today and the result is as good of a scenario as anyone could hope for for this family.  It should allow him to live the rest of his life without the need for another heart surgery.

Dr. Turrentine giving some refreshing water to Hawra. 

Batoul is 2 years old and had a large hole between the top two chambers of her heart closed today. The operation was a success and she is recovering well in the ICU.

Sireen had another good night. We are decreasing her breathing support today and starting to give her better nutrition today. 

Sireen and her mother.

Qasem had a great night. He is starting to breast feed and we are decreasing breathing support.  

Dr. De Jesus apparently does not have the magic touch with Qasem.

Jouri is still in intermittent heart block after her operation but it is improved and Dr. Bassam wants to wait a bit longer before deciding whether to place a pacemaker. 

The team is happy but Jouri is not about having her chest tubes out. 

Mira is doing much better. Her mother has noticed a major improvement. Her lungs need to open up some, so we brought a trick from home to the Middle East.

Mira blowing bubbles. 

Jana is cruising after surgery to fix the large hole between the bottom two chambers of her heart. She was at high risk for a difficult first night after surgery but did not have any problems. 

Jana with Dr. Yabrodi sharing some gifts from home. 

Mazin has chest tubes pulled today and will probably be discharged tomorrow. We are so happy for this boy and his father that his recovery has been swift. 

Zainalabideen needs one more day for his chest tube to drain, but it should pulled tomorrow.

Zainalabideen with Dr. De Jesus and his Riley soccer ball.

Abdel Qader is making life easy for the team after surgery. She was agitated for several hours after her surgery but had been the perfect patient since then.

If Abdel Qader is well behaved then Sewar is simply showing off. She doesn’t know she had open heart surgery yesterday. 

Sewar the showoff!

Friday is a weekend day in Jordan so the team will get some much needed rest before finishing off the mission on Saturday and heading for home the following day. 

Written by stephkinnaman

August 29, 2019 at 11:41 pm

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