The Early Days of Cardiac Surgery in South Asia: The History and Heritage

Hosain, Nazmul

doi:10.1016/j.athoracsur.2017.01.039

Cited by 16 publications

(25 citation statements)

References 15 publications

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“…The first South Asian cardiac surgery was the closure of a stab wound to the left ventricle by an Indian surgeon in 1946. (14) In the ensuing seven decades, the field of cardiac surgery in the whole region has been revolutionized with many 'firsts' in most south Asian countries, viz.…”

Section: Introductionmentioning

confidence: 99%

“…India, Pakistan, Nepal, Bangladesh, Sri Lanka and Afghanistan. 14,15 There have been reports depicting periods of stagnation and those of inspiration from many developing nations in the African subcontinent and elsewhere. 6,8,12,13,16 In south Asia, cardiac surgery has not been reported from 'tiny Bhutan and the Maldives'.…”

Section: Introductionmentioning

confidence: 99%

“…6,8,12,13,16 In south Asia, cardiac surgery has not been reported from 'tiny Bhutan and the Maldives'. 14…”

Section: Introductionmentioning

confidence: 99%

“…There have been examples of 'medical missions' to help start a program, but it has been repeatedly demonstrated that it takes a 'home-grown' team to sustain the program and take it to a greater heights 6,8,9,14,. 27 …”

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confidence: 99%

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Early Experience of Cardiac Surgery in the Maldives

Sapkota

Sattar

Shafiu

et al. 2019

Journal of Institute of Medicine

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…6,8,12,13,16 In south Asia, cardiac surgery has not been reported from 'tiny Bhutan and the Maldives'. 14…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Early Experience of Cardiac Surgery in the Maldives

Sapkota

Sattar

Shafiu

et al. 2019

Journal of Institute of Medicine

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“…8 Some bold general surgeons performed at few digital mitral commissurotomy in late 1960s at Dhaka Medical College Hospital and the then Chest Hospital, which is the National Institute of the Diseases of Chest and Hospital today. 9 After establishment of National Institute of Cardiovascular Diseases (NICVD) in 1978, CMC became the most frequently performed cardiac surgical procedure and remained so till the beginning of the Twenty-first century. With the advent of percutaneous transluminal mitral Commissurotomy (PTMC) this procedure has become near obsolete.…”

Section: Introductionmentioning

confidence: 99%

Per-operative Changes of Pulmonary Artery Pressure following Closed Mitral Commissurotomy

et al. 2019

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Background: Mitral stenosis is often present with pulmonary hypertension. Closed Mitral Commissurotomy (CMC) is a treatment of choice for severe mitral stenosis. In this study, we examined the per-operative changes of pulmonary artery pressure following opening of stenosed mitral valve. Methods: All these CMCs were performed routinely through the left antero-lateral thoracotomy (4th intercostal space) and dilatation was done by metallic Tubb’s Dilator. Peroperative left atrial and Pulminary Arterial pressures were measured before and after dilatation. Results: 15 patients had undergone CMC. Following CMC, per-operative mean Pulmonary artery pressure was reduced from 45.5±7.1 mm of Hg to 39.0±8.8 mm of Hg (p=0.043). Mean left atrial pressure reduced from 35.9±5.6 mm of Hg to 30.0±9.1 mm of Hg (p = 0.049). At three months follow up after closed mitral commissurotomy mitral valve area at echocardiography was found 2.29±0.18 cm2. There was no case of death after closed mitral commissurotomy. Mild mitral regurgitation occurred in 1 patient. Conclusion: We conclude that there is immediate significant reduction of pulmonary Artery pressure following closed mitral commissurotomy. This reduction is apparently comparable with a similar reduction of left atrial pressure. Cardiovasc. j. 2019; 11(2): 147-151

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