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Results of international assistance for a paediatric heart surgery programme in a single Ukrainian centre

Igor V Polivenok1, Frank J Molloy2, Christian L Gilbert3

  • 11Zaitcev Institute for General and Urgent Surgery,Kharkiv,Ukraine.

Cardiology in the Young
|March 1, 2019
PubMed

Insights

An international surgical assistance program significantly improved congenital heart defect (CHD) surgery outcomes in a former Soviet Union center. The program increased surgical volume and complexity while reducing adjusted mortality rates.

Area of Science:

  • Cardiovascular Surgery
  • Global Health Initiatives
  • Pediatric Cardiology

Background:

  • Congenital heart defect (CHD) surgery development lagged in parts of the former Soviet Union.
  • An 8-year surgical assistance program was implemented between an emerging center and an international multidisciplinary team.
  • The program aimed to enhance surgical capacity and patient outcomes in pediatric cardiac care.

Purpose of the Study:

  • To analyze the impact of a long-term surgical assistance program on CHD surgery in an emerging center.
  • To evaluate changes in surgical volume, operative mortality, and case complexity.
  • To assess the development of independent surgical skills among local healthcare professionals.

Main Methods:

  • The international program involved annual clinical visits, medical education, biomedical engineering support, nurse empowerment, and team-based practice development.
  • Data from 2000-2007 (Era A) and 2008-2015 (Era B) were compared.
  • Key variables included annual case volume, operative mortality, and Risk Adjustment for Congenital Heart Surgery (RACHS-1) adjusted mortality.

Main Results:

  • Surgical volume increased from 19.3 cases/year in Era A to 103.1 cases/year in Era B (p<0.0001).
  • Operative mortality slightly increased from 4.6% to 5.7% (p=0.84), but the standardized mortality ratio decreased from 2.1 to 1.2 due to increased case complexity.
  • Local surgeon-led procedures rose from 0% to 98% by the program's end.

Conclusions:

  • The described assistance model successfully improved adjusted mortality rates for congenital heart surgery.
  • The program led to a significant increase in surgical case volume and complexity.
  • Independent operating skills among local surgeons were substantially enhanced.
Abstract

Keywords:
CHDinternational assistanceoutcomes

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