Challenges and possibilities of developing cardiac surgery in a peripheral hospital of low- and middle-income countries

Objective: Over a million cardiac surgeries are performed every year around the globe. However, approximately 93% of world population living in low- and middle-income countries have no access to cardiac surgery. The incidence of rheumatic and congenital heart disease is high in Nepal, while only 2,5...

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Bibliographic Details
Published in:Perfusion 2021-01, Vol.36 (1), p.38-43
Main Authors: Tiwari, Kaushal K, Grapsa, Julia, Laudari, Shankar, Pazdernik, Michal, Vervoort, Dominique
Format: Article
Language:English
Subjects:
Cardiovascular disease
Cardiovascular diseases
Coronary artery disease
Developing countries
Heart diseases
Heart surgery
Income
LDCs
Low income groups
NGOs
Nongovernmental organizations
Patients
Rheumatic heart disease
Surgery
World population
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Summary:Objective: Over a million cardiac surgeries are performed every year around the globe. However, approximately 93% of world population living in low- and middle-income countries have no access to cardiac surgery. The incidence of rheumatic and congenital heart disease is high in Nepal, while only 2,500-3,000 cardiac surgeries are performed annually. The aim of our study is to analyze challenges and opportunities of establishing a cardiac surgery program in a peripheral hospital of Nepal. Methods: We analyzed our effort to establish a cardiac surgery program in a peripheral hospital in Nepal. Results: Out of 2,659 consulted and diagnosed patients, we performed 85 open-heart surgeries in 4 years. Mean age of patients was 38.35 ± 14.13 years. The majority of patients were male (62.4% of patients) with 65.9% suffering from rheumatic heart disease. Average intensive care unit stay and hospital stay were 2.32 ± 1.1 and 8.29 ± 2.75 days, respectively. No in-hospital mortality was observed. Conclusion: We conclude that developing cardiac surgical care in a peripheral hospital of a developing country is feasible with support from government, foreign colleagues, local teams, and non-governmental organizations. The availability of a regular cardiac surgery service in the periphery of the country makes such services more accessible for the patients and helps in reducing the long waiting lists and unmanageable workload in the established cardiac centers in the capital city.
ISSN:0267-6591
1477-111X
DOI:10.1177/0267659120924923