Early Experience of Cardiac Surgery in the Maldives

• Published in: Journal of Institute of Medicine Nepal 2019-04, Vol.41 (1), p.52-66
• Main Authors: Sapkota, Ranjan, Shafiu, Mohamed, Razzag, Dusooma A, Patil, Priyanka B, Sadoon, Haytham M Y, Abouhabiba, Karim M, Vivehananthan, Sivaranjani P, Shinde, Dipti S, Moosa, Mohamed F, Sattar, Fathmath A A, Gautam, Mani P, Bhadauria, Prateek S, Shafeeq, Ali
• Format: Article
• Language: English
• ISSN: 1993-2979; 1993-2987
• DOI: 10.3126/jiom.v41i1.28601

Introduction:From stitching a heart wound to the current level of sophistication, cardiac surgery has come a long way as a discipline. Heart surgery in South Asia has advanced tremendously; both, quantitatively and qualitatively. This is a report of the first fifteen surgeries done in the Maldives where cardiac surgery has started as an organized program. Methods: Data on the first fifteen consecutive cardiac surgeries done in our hospital, over a period of 7 months, was analyzed. We briefly describe our usual perioperative management, and the pretext of the beginning of the cardiac surgery program. Results: Fifteen patients, 13 males, aged 59.9±13.8 years, with a EuroScore of 0.9±0.4%, were operated. Eleven underwent CABG; and four had a valve replacement. Nine out of 11 had TVD, including 6 who had an LMCA disease. The first surgery was an off-pump CABG. The CABG group had a total of 2-5 grafts. Pump and cross-clamp times were 239.6 (± 56.1) min and 154.2 (± 45) min respectively. Five (33.3%) had at least one non-fatal complication. Two (13.2%) required re-exploration for mediastinal bleeding. The length of hospital stay was 16.5 days (±6.9 days). The chest tubes stayed for an average of 4.8 (±0.7) days. There was no in-hospital, 30-day and 90-day mortality recorded. Conclusion: Cardiac surgery has begun in the Maldives. It is safe and feasible to sustain cardiac surgery program in the country, provided continued national support and international collaboration is ensured.