Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-26T06:33:00.876Z Has data issue: false hasContentIssue false
  • English
  • Français

Are we improving after 10 years of humanitarian paediatric cardiac assistance?

Published online by Cambridge University Press:  13 July 2005

William M. Novick ,
Gregory L. Stidham ,
Thomas R. Karl ,
Karen L. Guillory ,
Visnja Ivanćan ,
Ivan Malčić ,
Nestor Sandoval ,
Robert W. Reid ,
Vasily V. Lazorishisnets  and
Matthew C. Davis
...Show all authors
William M. Novick
Affiliation:
Department of Surgery, University of Tennessee-Memphis, United States of America Department of Pediatrics, University of Tennessee-Memphis, United States of America International Children's Heart Foundation, Memphis, Tennessee, United States of America
Gregory L. Stidham
Affiliation:
Department of Pediatrics, University of Tennessee-Memphis, United States of America International Children's Heart Foundation, Memphis, Tennessee, United States of America
Thomas R. Karl
Affiliation:
Division of Pediatric Cardiothoracic Surgery, University of California-San Francisco, United States of America International Children's Heart Foundation, Memphis, Tennessee, United States of America
Karen L. Guillory
Affiliation:
International Children's Heart Foundation, Memphis, Tennessee, United States of America
Visnja Ivanćan
Affiliation:
Department of Surgery; Departments of Cardiac Surgery and Pediatrics, KBC-Zagreb, Rebro University Hospital, Zagreb, Croatia International Children's Heart Foundation, Memphis, Tennessee, United States of America
Ivan Malčić
Affiliation:
Department of Surgery; Departments of Cardiac Surgery and Pediatrics, KBC-Zagreb, Rebro University Hospital, Zagreb, Croatia
Nestor Sandoval
Affiliation:
Department of Cardiac Surgery, Fundacion Abood Shaio, Bogotá, Colombia
Robert W. Reid
Affiliation:
International Children's Heart Foundation, Memphis, Tennessee, United States of America
Vasily V. Lazorishisnets
Affiliation:
Department of Congenital Heart Disease, Kyiv Institute of Cardiovascular Surgery, Kyiv, Ukraine
Matthew C. Davis
Affiliation:
International Children's Heart Foundation, Memphis, Tennessee, United States of America
Victor C. Baum
Affiliation:
Department of Anesthesiology, Pediatrics and the Cardiovascular Research Center, University of Virginia, United States of America
Thomas G. Di Sessa
Affiliation:
Department of Pediatrics, University of Kentucky, United States of America International Children's Heart Foundation, Memphis, Tennessee, United States of America
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Paediatric cardiovascular services are frequently absent or poorly developed in many countries around the world. Our foundation made 83 trips in support of cardiovascular services between April 1993 and March 2003 to help alleviate this problem. In this study, we present an analysis of our results over these period of 10 years. Methods: We performed a review of all available records relating to the trips, including patient databases, audited financial statements, donated product inventory lists, lists of team members, and follow-up data from the host sites concerning the state of the patients treated. Results: We made 83 trips to 14 countries, 40 of these being in Central Europe, 5 in Eastern Europe, 10 in Caribbean, and Central America, 18 in South America, 9 in Asia, and 1 in the Middle East. In the first 5 years, we made 23, as opposed to 60 in the second 5 years, this difference being significant (p less than 0.01). The total number of primary operations performed over 10 years was 1,580. The number of procedures performed yearly increased over the two intervals from 97.0 plus or minus 32.7 to 219.0 plus or minus 41.7, p less than 0.002. The probability of survival between the periods increased from 84.6 to 93.3 per cent, and this was also significantly different (p less than 0.001). Overall, the rate of survival for the period of 10 years was 90.5 per cent. Moreover, the value of services donated to support each trip also differed significantly, decreasing from 105,900 dollars plus or minus 14,581 dollars for the first period to 54,617 dollars plus or minus 11,425 dollars for the second period (p less than 0.001). Conclusions: Improving paediatric cardiac services in under-served countries requires significant financial and personnel commitments, but can produce reasonable outcomes.

Keywords

Congenital heart diseaseinternational medicinenon-governmental aid agencies
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 4 , August 2005 , pp. 379 - 384
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cohen AJ, Tamir A, Houri S, et al. Save a child's heart: we can and we should. Ann Thorac Surg 2001; 71: 462–468.Google Scholar
Pezzella AT. International aspects of cardiac surgery. Ann Thorac Surg 1998; 65: 903–904.Google Scholar
McGrath LB. Establishing a pediatric cardiac surgical unit in the Commonwealth of Independent States (formerly the Soviet Union) (Letter). J Thorac Cardiovasc Surg 1992; 104: 1758–1759.Google Scholar
Jenkins KJ, Gauvreau K, Newberger JW, Spray TL, Moller JH, Iezzoni LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg 2002; 123: 110–118.Google Scholar
Borst JG. The hammer, the sickle, and the scalpel: a cardiac surgeon's view of Eastern Europe. Ann Thorac Surg 2000; 69: 1655–1662.Google Scholar
Kalangos A. “Hearts for all”: a humanitarian association for the promotion of cardiology and cardiac surgery in developing countries (Correspondence). Ann Thorac Surg 2002; 73: 341.Google Scholar
Lansing LM. Heart surgery in underdeveloped countries. Success in Panama and Romania (Letter). Ann Thorac Surg 1993; 56: 1439–1440.Google Scholar
Pezzella AT. Global expansion of cardiac surgery in the New Millennium. Asian Cardiovasc Thorac Ann 2001; 9: 253–256.Google Scholar
De Luna AB. International cooperation in world cardiology: the role of the world heart federation. Circulation 1999; 99: 986–989.Google Scholar
Pezzella AT. Progress in international cardiac surgery: emerging strategies. Ann Thorac Surg 2001; 71: 407–408.Google Scholar
Cohen AJ. “Hearts for all”: a humanitarian association for the promotion of cardiology and cardiac surgery in developing countries (Reply). Ann Thorac Surg 2002; 73: 341–342.Google Scholar
Pezzella AT. Worldwide misdistribution of access to cardiac surgery (Letter). J Thorac Cardiovasc Surg 2002; 123: 1016.Google Scholar
Cox JL. Presidential address: changing boundaries. J Thorac Cardiovasc Surg 2001; 122: 413–418.Google Scholar
Shekerdemian LS, Penny DJ, Novick W. Early extubation after surgical repair of tetralogy of Fallot. Cardiol Young 2000; 10: 636–637.Google Scholar
Novick WM, Gurbuz AT, Watson DC, et al. Double patch closure of ventricular septal defect with increased pulmonary vascular resistance. Ann Thor Surg 1998; 66: 1533–1538.Google Scholar
Anyanwu AC, Treasure T. Unrealistic expectations arising from mortality data reported in the cardiothoracic journals. J Thorac Cardiovasc Surg 2002; 123: 16–20.Google Scholar
Mavroudis C, Jacobs JP. Congenital hear disease outcome analysis: methodology and rationale. J Thorac Cardiovasc Surg 2002; 123: 6–7.Google Scholar
Jenkins KJ, Gauvreau K. Center-specific differences in mortality: preliminary analyses using the risk adjustment in congenital heart surgery (RACHS-1) method. J Thorac Cardiovasc Surg 2002; 124: 97–104.Google Scholar
Blackstone EH. Comparing apples and oranges. J Thorac Cardiovasc Surg 2002; 123: 8–15.Google Scholar
Chang AC. How to start and sustain a successful pediatric cardiac intensive care program: A combined clinical and administrative strategy. Pediatr Crit Care Med 2002; 3: 107–111.Google Scholar
Neirotti R. Paediatric cardiac surgery in less privileged parts of the world. Cardiol Young 2004; 14: 341–346.Google Scholar