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Global unmet needs in cardiac surgery
Zilla, Peter Yacoub, Magdi H. Zuhlke, Liesl Joanna Beyersdorf, Friedhelm Sliwa-Hahnle, Karen Khubulava, Gennadiy Bouzid, Abdelmalek Mocumbi, Ana O. Velayoudam, Devagourou Shetty, Devi
Zilla, Peter
Yacoub, Magdi H.
Zuhlke, Liesl Joanna
Beyersdorf, Friedhelm
Sliwa-Hahnle, Karen
Khubulava, Gennadiy
Bouzid, Abdelmalek
Mocumbi, Ana O.
Velayoudam, Devagourou
Shetty, Devi
Author
Zilla, Peter
Yacoub, Magdi H.
Zuhlke, Liesl Joanna
Beyersdorf, Friedhelm
Sliwa-Hahnle, Karen
Khubulava, Gennadiy
Bouzid, Abdelmalek
Mocumbi, Ana O.
Velayoudam, Devagourou
Shetty, Devi
Ofoegbu, Chima
Geldenhuys, Agneta
Brink, Johan
Scherman, Jacques
du Toit, Henning
Hosseini, Saeid
Zhang, Hao
Luo, Xin-Jin
Wang, Wei C.
Mejia, Juan
Kofidis, Theodoros
Higgins, Robert S. D.
Pomar, Jose
Bolman, R. Morton
Mayosi, Bongani
Madansein, Rajhmun
Bavaria, Joseph
Yanes-Quintana, Alberto A.
Kumar, A. Sampath
Adeoye, Oladapo
Chauke, Risenga Frank
Williams, David F.
Yacoub, Magdi H.
Zuhlke, Liesl Joanna
Beyersdorf, Friedhelm
Sliwa-Hahnle, Karen
Khubulava, Gennadiy
Bouzid, Abdelmalek
Mocumbi, Ana O.
Velayoudam, Devagourou
Shetty, Devi
Ofoegbu, Chima
Geldenhuys, Agneta
Brink, Johan
Scherman, Jacques
du Toit, Henning
Hosseini, Saeid
Zhang, Hao
Luo, Xin-Jin
Wang, Wei C.
Mejia, Juan
Kofidis, Theodoros
Higgins, Robert S. D.
Pomar, Jose
Bolman, R. Morton
Mayosi, Bongani
Madansein, Rajhmun
Bavaria, Joseph
Yanes-Quintana, Alberto A.
Kumar, A. Sampath
Adeoye, Oladapo
Chauke, Risenga Frank
Williams, David F.
Abstract
More than 6 billion people live outside industrialized countries and have insufficient access to cardiac surgery. Given the recently confirmed high prevailing mortality for rheumatic heart disease in many of these countries together with increasing numbers of patients needing interventions for lifestyle diseases due to an accelerating epidemiological transition, a significant need for cardiac surgery could be assumed. Yet, need estimates were largely based on extrapolated screening studies while true service levels remained unknown. A multi-author effort representing 16 high-, middle-, and low-income countries was undertaken to narrow the need assessment for cardiac surgery including rheumatic and lifestyle cardiac diseases as well as congenital heart disease on the basis of existing data deduction. Actual levels of cardiac surgery were determined in each of these countries on the basis of questionnaires, national databases, or annual reports of national societies. Need estimates range from 200 operations per million in low-income countries that are nonendemic for rheumatic heart disease to >1,000 operations per million in high-income countries representing the end of the epidemiological transition. Actually provided levels of cardiac surgery range from 0.5 per million in the assessed low- and lower-middle income countries (average 107 ± 113 per million; representing a population of 1.6 billion) to 500 in the upper-middle-income countries (average 270 ± 163 per million representing a population of 1.9 billion). By combining need estimates with the assessment of de facto provided levels of cardiac surgery, it emerged that a significant degree of underdelivery of often lifesaving open heart surgery does not only prevail in low-income countries but is also disturbingly high in middle-income countries.
Keywords
Date
2018
Type
Journal article
Journal
Global Heart
Book
Volume
13
Issue
4
Page Range
293-303
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC-ND 4.0
File Access
Open