Posted by Jess Socrates on Jul 11, 2019
Copying to you report I sent to Kathleen Stoupe.
The attached collage was the picture I shared with the Club last meeting.
Our total number of patients for Operation Braveheart has gone up to 73
The collage for patients # 65 - 72 is attached. 
Of the 73 patients, 47 or 64% were PDA's; the rest of the 26 or 36% were the more complicated and more expensive cases (ASD, VSD, Pulmonic stenosis).
Grand total since start of project: 115 patients.
Based on the most recent financial report I received from Rotary Club of Makati Southeast, we still have funds left for approximately 20 more patients - if all are PDA's. The goal of this grant as stated in the application was to repair 86 patients so, I think, we will meet this goal.
We had a morbidity on one of the children. DENIEL A. (lower left on the collage). Here are Jonas' notes on him:
This is a 4.5 kg 7 month old infant with failure to thrive. Cardiac cath showed an elevated pulmonary artery pressure secondary to a left to right shunt from a relatively large PDA. We were able to successfully implant an 8-6 Hyperion PDA occluder. The position of the occluder was satisfactory based on the last angiogram. 
According to the mother, when the patient woke up, he cried continuously and couldn't be pacified. She tried breastfeeding but the baby refused. There was a good 30 minutes of continuous crying until the baby went back to sleep. It may very well be (no proof) that this triggered acute rise in the pulmonary artery pressure which may cause the occluder to move towards (embolize) the aorta. On hindsight, the patient should have been sedated longer. When we did our daily rounds at the end of the day, the baby was noted to have a recurrence of the heart murmur which sounded like a PDA. 2D echo revealed a PDA and chest xray revealed the occluder in the aorta (T6-T7 level). We alerted our surgical team and emergency PDA ligation and retrieval of embolized PDA device was done under general anesthesia in the OR.  Dr Carlo Garcia did the procedure.
Operation Braveheart will pay additional hospital expenses for this ~ 55,000 pesos (we will take this off the "contingency fund" component of the grant).
We continue to work on the interim report for Braveheart II.
I did not do the survey. Will work on this if and when we get approval for the Street children grant.
Will comment on the "stricter rules" for grants later.
-Jess Socrates