ObjectivesThe South Asian neighboring countries of India include Bangladesh, Bhutan, Nepal, The Maldives, Pakistan and Sri Lanka. Interestingly all these countries possess either a land or a sea border with India and no border among themselves. These countries have historic, cultural, ethnic and genetic links with India. The paper describes the developmental history and current status of cardiac surgery in these countries.MethodsThorough search of the printed and electronic materials has been made. The authors visited all these countries and contacted the eminent surgeons personally or through mails. All the information is cross-checked and compiled. Record keeping is not well organized in most of these countries. Best information often came from unusual sources like Anesthetists’ society or the corporate houses.ResultsFour of these countries Bangladesh, Nepal, Pakistan and Sri Lanka have their cardiac surgical programs. Collectively they perform around 38000 cardiac operations a year which is a quarter of the cases performed in India. These countries are important sources of medical tourism in India which is worth 3 billion US$ of business annually.ConclusionWhen the number of operations per million populations is considered, Bangladesh and Nepal are lagging behind India where as Pakistan has a comparable figure. Sri Lanka with 265 cardiac operations/million populations has the best figures in the region. However when compared with the Western countries even the Lankan figures also look quite inadequate.

Objective: To evaluate the demographics of patients admitted with Hypertrophic Obstructive Cardio-Myopathy (HOCM) and the financial burden of this disease on the health care system. Methods:The Healthcare Cost and Utilization Project (HCUP), sponsored by The Agency for Healthcare Research and Quality's (AHRQ), includes the largest collection of longitudinal hospital care data in the United States of America. HCUP creates the National In-patient Sample data (NIS) to help conduct national and regional analyses of inpatient care. Using the NIS data (2013), we performed a retrospective cohort study that involved patients who were admitted and treated for HOCM.Results: A total of 2605 patients were admitted for the principal diagnosis of HOCM in 2013.Mean hospitalization was 4.9 days. In our total population, 33% of the patients were above 64 years of age. Mean cost of admission was 25,433$. Private insurance and Medicare or Medicaid paid for 43% and 47% admissions respectively. 76%, 3.5%, 4.6% and 13% patients were discharged to routinely home, another short term hospital, nursing home and for home health care, respectively.Conclusions: HOCM admissions are relatively uncommon but effects all ages. Most of these patients were treated at a private hospital, and the hospital costs were very high. Large number of patients required rehabilitation services after discharge which increase financial burden on health care system.

Objective: To investigate the early outcomes of patients undergoing total-correction (TC) for Tetralogy of Fallot (TOF). Methodology: A retrospective study was carried out after acquiring Institutional ethical review committee approval. All patients diagnosed with TOF combined with pulmonary stenosis that had undergone primary repair between November 2016 and November 2018 at the Cardiothoracic Surgery Unit of Rehman Medical Institution, Peshawar were included while patients having anatomical defects alongside TOF were excluded from the study. Data was collected using a proforma. SPSS version 25 format was used for data entry and analysis. Comparisons between age related intraoperative parameters and age related early outcomes of the procedure was done by using the Student’s T-test and Chi-squared test keeping p ≤ 0.05 as significant. Results: A total of 186 patient’s data was retrieved from the hospital record. There were 109 (58.60%) males and 77 (41.40%) females. Mean cardiopulmonary bypass time (CBP) was 94.84±37.92 minutes and aortic cross clamp (ACC) time was 67.17±31.86 minutes. In the postoperative period, 11 (5.91%) patients developed Low cardiac output syndrome (LCOS).  Prolonged ventilator support (>24 hrs.) was required in 21(11.29%) patients and prolonged ICU stay (>48 hrs.) was seen in 38(20.43%) patients. A total of 166 (89.25%) patients were discharged while 20 (10.75%) died post operatively due to complications. Conclusion: Total repair for TOF is a favorable option in most patients as early outcomes were satisfactory with acceptable mortality rate after surgery.