Department of Cardiothoracic & Vascular Surgery, College of Medical Sciences, Teaching Hospital, Bharatpur, Nepal.
Department of Cardiology, Barts Hospital, London, UK.
Perfusion. 2021 Jan;36(1):38-43. doi: 10.1177/0267659120924923. Epub 2020 May 27.
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.
We analyzed our effort to establish a cardiac surgery program in a peripheral hospital in Nepal.
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.
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.
全球每年进行超过一百万例心脏手术。然而，约 93%生活在中低收入国家的世界人口无法获得心脏手术。尼泊尔风湿性和先天性心脏病的发病率很高，而每年仅进行 2500-3000 例心脏手术。我们研究的目的是分析在尼泊尔一家外围医院建立心脏手术项目的挑战和机遇。
我们分析了在尼泊尔一家外围医院建立心脏手术项目的努力。
在 2659 名咨询和诊断的患者中，我们在 4 年内进行了 85 例心脏直视手术。患者的平均年龄为 38.35±14.13 岁。大多数患者为男性（患者的 62.4%），其中 65.9%患有风湿性心脏病。平均重症监护病房停留时间和住院时间分别为 2.32±1.1 天和 8.29±2.75 天。无院内死亡。
我们得出结论，在发展中国家的外围医院开展心脏外科护理是可行的，这需要得到政府、外国同事、当地团队和非政府组织的支持。在该国偏远地区提供定期心脏手术服务，使这些服务更容易为患者获得，并有助于减少首都既定心脏中心的长期候补名单和难以管理的工作量。
