Related Experiment Video
Updated: Nov 9, 2025

Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
United in Earnest: First Pilot Sites for Increased Surgical Capacity for Rheumatic Heart Disease Announced by Cardiac
Zachary Obinna Enumah1, Ralph Morton Bolman1, Peter Zilla1
1Cardiac Surgery Intersociety Alliance.
Insights
The Cardiac Surgery Intersociety Alliance (CSIA) was formed to improve cardiac surgery access for rheumatic heart disease (RHD) patients. Two pilot sites in Mozambique and Rwanda were selected to advance this critical global health initiative.
Area of Science:
- Global Health
- Cardiovascular Surgery
- Public Health Policy
Background:
- Rheumatic heart disease (RHD) disproportionately affects over 33 million individuals in low- and middle-income countries.
- The Cape Town Declaration (2018) marked a global commitment to enhance RHD patient care.
- This declaration laid the groundwork for the formation of the Cardiac Surgery Intersociety Alliance (CSIA).
Purpose of the Study:
- To detail the history, formation, and activities of the CSIA.
- To outline the alliance's ongoing efforts and future strategic directions.
- To announce the selected pilot sites for improving cardiac surgery access.
Main Methods:
- The CSIA is an international alliance of cardiothoracic surgical societies and the World Heart Federation.
- Activities include conference meetings, recruitment efforts, and establishing selection criteria for support.
- Criteria focused on local capacity, leadership, support, identified care gaps, and research interest.
Main Results:
- Eleven applications were received for CSIA support.
- Three finalist sites underwent site visits.
- Hospital Central Maputo (Mozambique) and King Faisal Hospital Kigali (Rwanda) were selected as pilot sites.
Conclusions:
- Significant progress has been achieved since the Cape Town Declaration and CSIA formation.
- Continued collaboration among cardiac surgery, cardiology, industry, and government is essential.
- Sustained efforts are crucial to improve access to life-saving cardiac surgery for RHD patients globally.
Background:
Rheumatic heart disease (RHD) affects more than 33,000,000 individuals, mostly from low- and middle-income countries. The Cape Town Declaration On Access to Cardiac Surgery in the Developing World was published in August 2018, signaling the commitment of the global cardiac surgery and cardiology communities to improving care for RHD patients.
Methods:
As the Cape Town Declaration formed the basis for which the Cardiac Surgery Intersociety Alliance (CSIA) was formed, the purpose of this article is to describe the history of the CSIA, its formation, ongoing activities, and future directions, including the announcement of selected pilot sites.
Results:
The CSIA is an international alliance consisting of representatives from major cardiothoracic surgical societies and the World Heart Federation. Activities have included meetings at annual conferences, exhibit hall participation for advertisement and recruitment, and publication of selection criteria for cardiac surgery centers to apply for CSIA support. Criteria focused on local operating capacity, local championing, governmental and facility support, appropriate identification of a specific gap in care, and desire to engage in future research. Eleven applications were received for which three finalist sites were selected and site visits conducted. The two selected sites were Hospital Central Maputo (Mozambique) and King Faisal Hospital Kigali (Rwanda).
Conclusions:
Substantial progress has been made since the passing of the Cape Town Declaration and the formation of the CSIA, but ongoing efforts with collaboration of all committed parties-cardiac surgery, cardiology, industry, and government-will be necessary to improve access to life-saving cardiac surgery for RHD patients.
Related Concept Videos
Rheumatic Heart Disease III: Medical Management
Rheumatic Heart Disease I: Introduction
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
Rheumatic Heart Disease IV: Nursing Management
Mitral Stenosis III: Medical Management
Aortic Regurgitation III: Medical Management

