Establishing a High-Quality Congenital Cardiac Surgery Program in a Developing Country: Lessons Learned

Area of Science:

• Cardiology
• Pediatric Surgery
• Global Health

Background:

• Developing countries face significant challenges managing congenital heart disease (CHD) due to resource limitations.
• Pediatric cardiac surgery outcomes are often suboptimal in these regions, with few sustainable programs.

Purpose of the Study:

• To describe the establishment of a high-quality, in-situ pediatric cardiac surgery program in Lebanon, a resource-limited nation.
• To demonstrate the feasibility of achieving excellent surgical outcomes in a developing country context.

Main Methods:

• Conducted a retrospective analysis of 856 pediatric patients undergoing cardiac surgery for CHD between 2014-2018.
• Implemented a financial support model involving government, private hospital, and philanthropic organizations.
• Collected data on surgical procedures, patient demographics, outcomes, and financial contributions.

Main Results:

• 856 patients underwent 993 procedures over 5 years, with 2.8% overall mortality, comparable to international benchmarks.
• A tripartite Public, Private, and Philanthropy (3P) system covered 98% of costs, with an average cost of $19,800 per patient.
• Neonates and infants comprised over 45% of the patient cohort.

Conclusions:

• High-standard pediatric cardiac surgery is achievable in limited-resource settings.
• A sustainable financial model (3P system) can facilitate high-caliber care for children with CHD in developing countries.