Amid Conflict and COVID, TSF Award Recipient Takes Screening Tools to Armenia

STS News, Summer 2021 — During a year confounded by a pandemic and war in Armenia, a Thoracic Surgery Foundation (TSF) grant recipient began laying the groundwork for a congenital heart screening program in the country’s capital city.

Harma K. Turbendian, MD, with sponsorship from a TSF Every Heartbeat Matters Award, traveled to Yerevan in March 2021 with the goal of advancing Armenia’s cardiac care system.

“Armenia is lacking in both prenatal and postnatal heart screening,” said Dr. Turbendian, from Children’s Hospital of Illinois at OSF Healthcare in Peoria. “That’s especially true outside of the capital city, where medical care is not as good. It also applies to adult cardiac screening programs, and there is a pretty high prevalence of risk factors for acquired structural heart disease in Armenia.”

Dr. Turbendian assisted the Armenian surgical team with congenital heart surgeries scheduled in anticipation of his visit.

The TSF Every Heartbeat Matters Award provides support for programs that educate, screen, and/or treat underserved populations to reduce the global burden of heart valve disease.

Dr. Turbendian’s team is working to establish a comprehensive database to capture referrals for intervention and follow-up in patients found to have structural heart disease. Using the database, they will recommend interventions—at the facilities in Yerevan best equipped to provide the necessary medical care—and potential improvements in the patients’ lifestyles. They will focus especially on patients from underserved areas based on their location and history.

Restrictions imposed during COVID-19 and the Nagorno-Karabakh conflict added logistical challenges and cut Dr. Turbendian’s visit short, but during his time in Yerevan, he was able to arrange for the needed equipment deliveries to the sites. Now that he has returned to the US, he’s working remotely with clinicians at Nork Marash Medical Center to establish connections and enroll patients. Approximately 25 clinicians have received training in the interim.

“COVID cases were in their second peak, so we couldn’t do much in terms of going outside of the capital city, and I wasn’t able to do any actual screening while I was there,” he explained. “What I did do is get laptops, tablets, and portable ultrasound echo probes out there, and now I’m in the process of setting up all the Cloud accounts so that we can start the screenings.”

He also was able to interact directly with patients. “The folks who came in weren’t really there for the screening program, but the staff at the hospital had arranged the schedule so that they had a week full of congenital cases, knowing that I was going to be there.”

Transporting thousands of dollars’ worth of equipment into a former Soviet country was no simple task, Dr. Turbendian discovered. His team worked through several customs brokers before procuring the correct paperwork that established their humanitarian intent and showed that they weren’t there to sell the equipment.

“I think it’s uncommon to the culture in countries like Armenia when you come in from the outside and don’t have any other motives for what you’re doing aside from the personal satisfaction you get from being able to help.”

Working with international brokers, Dr. Turbendian's team transported valuable equipment needed to help establish a congenital heart screening program.

The project was an extension of the work Dr. Turbendian began in 2018, with the support of the TSF Robert L. Replogle Traveling Fellowship Award. The congenital cardiac program there was set up by Hagop Hrayr Hovaguimian, MD, a congenital heart surgeon from Legacy Emanuel and Providence St. Vincent in Portland, Oregon, Dr. Turbendian explained.

“I knew of him before I received my Replogle fellowship, since he was a family acquaintance and a legend in Armenian health care. The work started during my relationship with him. And my background is Armenian, so it was kind of a natural progression of wanting to participate and getting back to my roots.”

Dr. Turbendian plans to return to Armenia soon, and he encourages other applicants to take advantage of the rich experiences and outreach opportunities that TSF awards provide. “Even though this particular trip couldn’t be as impactful as I wanted it to be, I am very thankful to have had the opportunity to take part in the Every Heartbeat Matters program, and that I was able to set things up for a potentially successful screening system,” he said. “Just going through the process really opened up a bunch of doors into opportunities to improve Armenian health care in general, and I’m indebted to this program for having opened those doors up for me.”


TSF Applications for 2022 Awards Open

Awards like Every Heartbeat Matters and the Replogle Traveling Fellowship are available for applicants interested in surgical outreach both locally and abroad.

The Thoracic Surgery Foundation (TSF) is accepting applications for 2022 awards through September 15, 2021. Offerings include grants for research, education, leadership, and surgical outreach. A full menu of options, along with specific submission criteria, can be found at thoracicsurgeryfoundation.org/awards.

In 2020, more than $1 million was awarded to 29 surgeons. So far in 2021, TSF already has provided $861,870 in research grants and educational scholarships, with plans to award another $250,000 in grants later in the year.

“Research grants, fellowships, and educational scholarships from TSF represent all of our disciplines and surgeons at all career stages,” said Foundation President Joseph E. Bavaria, MD. “The Foundation’s awards have been instrumental in developing hundreds of young surgeons by providing the support needed for their career advancement. These awards also have been important stepping stones in furthering innovation in cardiothoracic surgery.”

For more information on the Foundation, go to thoracicsurgeryfoundation.org or review the 2020 TSF Annual Report at thoracicsurgeryfoundation.org/2020annualreport.