September 4, 1998

Mina Poyraz, a young girl from Istanbul, Turkey, should not have had much to worry about at the tender age of 6. She was worried, however, and so were her family and her physicians.

Mina was diagnosed earlier this year with patent ductus arteriosus (PDA), a congenital condition characterized by an abnormal connection between the major arteries leaving the heart. This connection, which usually closes soon after birth, can be a source of infection or excessive strain on the heart.

Mina's physicians in Turkey contacted the MGH through the Partners Center for Clinical Telemedicine to consult with Richard Liberthson, MD, a cardiologist specializing in congenital heart disease. Mina's medical records were transferred to the MGH via fax – the most basic form of telemedicine. Liberthson concurred with Mina's physicians that a relatively simple coil catheter procedure would close the arterial connection, avoiding any surgery or later complications. At the request of the family and her physicians, Mina came to the MGH to have the procedure performed by Michael de Moor, MD, chief of the MGH Pediatric Cardiology Unit.

Aysin Poyraz, Mina's mother, worked closely with Partners Telemedicine staff to have all of Mina's records and exams sent to Liberthson and de Moor. Kathleen Kelleher of Partners Telemedicine was a liaison between the MGH clinicians and Mina's physicians in Turkey. "Even though we used telemedicine in its most basic form in Mina's case, this illustrates the promise that technological advances offer in terms of patient care, physician interaction and clinical knowledge sharing throughout the world," says Joseph Kvedar, MD, director of Partners Telemedicine.

When Mina arrived at the MGH with her mother and her aunt, the family was greeted by International Patient Center staff members, who provide nonclinical support to patients from other countries and cultures. Staff member Ayse Taciroglu, also from Turkey, helped the Poyraz family adapt to the Boston area during their short stay. Taciroglu helped them find local housing and assisted them with transportation to and from the hospital. The center staff also helps international patients with payment plans, currency exchange and other services.

On Mina's third day in Boston, she underwent the coil catheter procedure. Through a catheter inserted into a blood vessel in her groin, a miniscule coil was passed up through the heart to the connection between the arteries. The coil was then positioned to close the connection. Mina was discharged the following day with only a small bandage to show for her hospital stay.

Before heading home to Turkey, Mina and her family came back for a final follow-up exam. Mina's echocardiogram, performed by Mary Etta King, MD, director of Pediatric Echocardiography, indicated that the procedure was successful.

Mina's mother attributed her daughter's excellent outcome and their positive experience to the teamwork of Mina's physicians and nursing staff, Partners Telemedicine and the International Patient Center. "We are very happy that we came here," says Poyraz. "Everyone was so nice and cooperative. The staff made us feel right at home."

According to Liberthson, Mina should not require any surgery or follow-up care for her heart. "Mina is well on her way to returning to her normal life as a healthy and happy little girl," he says.