Cardiac surgery: the infinite quest

Neirotti, Rodolfo A.

doi:10.5935/1678-9741.20120104

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…But, there are many obstacles to be tackled. These obstacles fall into common categories: financial problems, political problems at both the national and local (institutional) levels, cultural differences such as organizational skills, lifestyles, and priorities, 17 and the proverbial “brain drain” not only to areas outside the country but also within it. 18 However, there are two cardiothoracic and vascular surgeons in the department, who decided to serve in the peripheral hospital of Nepal.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…The major issues to be considered before a site visit is made are; adequate infrastructure and accessibility of the hospital, local staff in all specialties to train, equipment needs (will need to reconfirm on site visit), locally available supplies and medications, philosophical support for program development from the local team, hospital administration, regional and national health directorates/ministries and local need for such a service. Invariably the media will become involved which one must remember can be good or bad for the local program if not handled appropriately (19).…”

Section: Request For Assistancementioning

confidence: 99%

Pediatric Cardiac Service Development Programs for Low- and Middle-Income Countries in Need of Improving or Initiating Local Services

Novick

Molloy

Bowtell³

et al. 2019

Front. Pediatr.

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Pediatric cardiac services are deficient in most of the world. Various estimates are that between 80 and 90% of the world's children do not receive adequate cardiac care for their congenital or acquired heart disease. We began a modest effort in 1992 to assist in the development of pediatric cardiac services in low- and middle-Income countries (LMIC). Since then, we have provided services in 32 countries based on 3 distinctive development strategies, in order to meet the local needs for pediatric cardiac services. Our goal has always been to provide education, training and sufficient experience so that eventually we leave a site with a fully functional, independently operating pediatric cardiac service that is sustainable over time. The margin between success and failure is dependent upon a number of factors and we hope that this chapter will provide others with the tools for success.

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“…The health care system goes beyond hospitals, doctors, nurses, and allied health care providers. A successful health care system requires governmental infrastructure, business and industry, university programs, society, and media [4]. Improvement in the quality of health care and reducing its costs requires a focus on the health care system as opposed to efforts focused on treating specific diseases.…”

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confidence: 98%

“…Innovation is essential for improvements in the health care systemboth product innovation (technologies, devices, and so forth) and process innovation (care pathways, algorithms, protocols, databases, and so forth). Improvements in the sciences need (1) knowledge development that adds value by processing existing information to define and solve problems; (2) cross-fertilization of ideas-networking and physical proximity of well-informed people who have time and resources to review, think, and experiment; (3) strong connections with university and industry; and (4) good governance-particularly with regard to legal protection of innovations [4][5][6].…”

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confidence: 99%

Humanitarian Outreach in Cardiothoracic Surgery: From Setup to Sustainability

Dearani

Jacobs

Bolman

et al. 2016

The Annals of Thoracic Surgery

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Noncommunicable diseases account for 38 million deaths each year, and approximately 75% of these deaths occur in the developing world. The most common causes include cardiovascular diseases, cancer, respiratory diseases, and diabetes mellitus. Many adults with acquired cardiothoracic disease around the world have limited access to health care. In addition, congenital heart disease is present in approximately 1% of live births and is therefore the most common congenital abnormality. More than one million children in the world are born with congenital heart disease each year, and approximately 90% of these children receive suboptimal care or have no access to care. Furthermore, many children affected by noncongenital cardiac conditions also require prevention, diagnosis, and treatment. Medical and surgical volunteerism can help facilitate improvement in cardiothoracic health care in developing countries. As we move into the future, it is essential for physicians and surgeons to be actively involved in political, economic, and social aspects of society to serve health care interests of the underprivileged around the world. Consequently, in developing countries, a critical need exists to establish an increased number of reputable cardiothoracic programs and to enhance many of the programs that already exist. The optimal strategy is usually based on a long-term educational and technical model of support so that as case volumes increase, quality improves and mortality and morbidity decrease. Humanitarian outreach activities should focus on education and sustainability, and surgical tourism should be limited to those countries that will never have the capability to have free-standing cardiothoracic programs.

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Cardiac surgery: the infinite quest

Cited by 4 publications

References 11 publications

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

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

Pediatric Cardiac Service Development Programs for Low- and Middle-Income Countries in Need of Improving or Initiating Local Services

Humanitarian Outreach in Cardiothoracic Surgery: From Setup to Sustainability

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