Establishing Cardiac Surgery in Eastern Nepal: Early Results

Area of Science:

• Cardiovascular Surgery
• Public Health
• Medical Outcomes

Background:

• Limited cardiac surgery services exist in Nepal, with few dedicated centers.
• This study originates from the sole government-affiliated cardiac center outside the capital.
• The need for accessible cardiac surgical care in Nepal is significant.

Purpose of the Study:

• To present the initial outcomes of cardiac surgery procedures performed at the B P Koirala Institute of Health Sciences.
• To evaluate the safety and feasibility of establishing open heart surgery services in a new region.
• To analyze early results including patient demographics, surgical types, and complications.

Main Methods:

• A retrospective analysis of 51 major cardiac surgeries performed between July 2016 and March 2017.
• Data collected included patient demographics, cardiac disease types, surgical methods (on-pump and off-pump), and postoperative outcomes.
• Key metrics analyzed were mortality, hospital and intensive care unit (ICU) stay, and valve-related complications.

Main Results:

• 51 major cardiac surgeries were performed, with 27 males and 24 females, median age 36 years.
• Rheumatic heart disease (28) and congenital heart diseases (12) were the most common diagnoses.
• In-hospital mortality was 7.8% (4 patients), with 91.8% of survivors in NYHA class I at 5-month follow-up. No prosthetic valve complications occurred.

Conclusions:

• The early results of cardiac surgery at this center are encouraging.
• The study establishes the safety and feasibility of initiating open heart surgery services in other regions of Nepal.
• These findings support the expansion of cardiac surgical care within the country.