Four Decades of Cardiac Surgery in Bangladesh: A Noble Journey That Started with the Help of Japan.

The first-ever open-heart operation in Bangladesh was performed on the 18th of September 1981. Although a few cases of finger fracture closed mitral commissurotomies were performed in the country in the 1960s and 1970s, full-fledged cardiac surgical services began only in Bangladesh after the establishment of the Institute of Cardiovascular Diseases at Dhaka in 1978. A Japanese team that includes cardiac surgeons, anesthetists, cardiologists, nurses, and technician came to Bangladesh and played an important role in the initiation of such a Bangladeshi endeavor. Bangladesh is a South Asian country with more than 170 million people living only in an area of 148460 square kilometers. Information was sought from the hospital records, old newspapers, books, and memoirs written by some of the pioneers. Pubmed and Internet search engines were also utilized. The principal author had personal correspondence with the available pioneering team members. The first open-heart operation was performed by visiting Japanese surgeon Dr. Komei Saji along with Bangladeshi surgeon duo Prof. M Nabi Alam Khan and Prof. S R Khan. Since then, cardiac surgery in Bangladesh has made a significant progress although it may not be enough to serve 170 million people. In 2019, twenty-nine centers performed a total of 12926 cases in Bangladesh. Remarkable advancement in cardiac surgery has been made in terms of cost, quality, and excellence in Bangladesh, but the country is lagging behind in the number of operations, affordability, and geographical distribution, which needs to be addressed for a better future.