Related Experiment Video
Updated: Apr 27, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Cardiac surgery capacity in sub-saharan Africa: quo vadis?
Charles Yankah1, Francis Fynn-Thompson2, Manuel Antunes3
1Department of Thoracic and Cardiovascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.
Insights
Developing sustainable cardiac surgery programs in Africa is hampered by limited data. The Ghanaian/German model, involving local senior surgeons, shows long-term success and can guide future cardiac care initiatives in sub-Saharan Africa.
Area of Science:
- Cardiovascular Surgery
- Global Health
- Surgical Workforce Development
Background:
- Limited and low-quality data exist on cardiac surgery capacity in Africa.
- Effective strategies for sustainable cardiac surgical programs are needed.
Purpose of the Study:
- To assess the current state of cardiac surgery in Africa.
- To identify successful models for developing sustainable cardiac surgical programs.
Main Methods:
- A questionnaire was distributed to 29 cardiac surgeons and cardiologists across 16 African countries.
- Data on practicing cardiothoracic surgeons were obtained from the Cardiothoracic Surgery Network (CTSNet).
Main Results:
- A response rate of 86.2% was achieved, with 25 respondents.
- Three models of cardiac surgery delivery were identified: local consultant-led, visiting humanitarian, and expatriate contract surgeons.
- Significant disparities in surgeon-to-population ratios and open-heart surgery rates were observed between North Africa and sub-Saharan Africa (SSA).
Conclusions:
- Humanitarian surgery is crucial for maintaining cardiothoracic healthcare delivery in SSA.
- The Ghanaian/German model demonstrates long-term success and offers a viable blueprint for establishing cardiac programs in Africa.
- Findings can inform health policy and guide senior surgeons in developing sustainable cardiac surgical initiatives.
Background:
Current data on cardiac surgery capacity on which to base effective concepts for developing sustainable cardiac surgical programs in Africa are lacking or of low quality.
Methods:
A questionnaire concerning cardiac surgery in Africa was sent to 29 colleagues-26 cardiac surgeons and 3 cardiologists in 16 countries. Further, data on numbers of surgeons practicing in Africa were retrieved from the Cardiothoracic Surgery Network (CTSNet).
Results:
There were 25 respondents, yielding a response rate of 86.2%. Three models emerged: the Ghanaian/German model with a senior local consultant surgeon (Model 1); surgeons visiting for a short period to perform humanitarian surgery (Model 2); and expatriate surgeons on contract to develop cardiac programs (Model 3). The 933 cardiothoracic surgeons listed by CTSNet translated into one surgeon per 1.3 million people. In North Africa, the figure was three surgeons per 1 million and in sub-Saharan Africa (SSA), one surgeon per 3.3 million people. The identified 156 cardiac surgeons represented a surgeon to population ratio of 1:5.9 million people. In SSA, the ratio was one surgeon per 14.3 million. In North Africa, it was one surgeon per 1.1 million people. Open heart operations were approximately 12 per million in Africa, 2 per million in SSA, and 92 per million people in North Africa.
Conclusion:
Cardiothoracic health care delivery would worsen in SSA without the support of humanitarian surgery. Although all three models have potential for success, the Ghanaian/German model has proved to be successful in the long term and could inspire health care policy makers and senior colleagues planning to establish cardiac programs in Africa.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:29Cardiomyopathy V: Interprofessional Care
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...