Related Experiment Video
Updated: Aug 7, 2025
Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country
Yayehyirad Mekonen Ejigu1, Hiwot Amare2
1Children's Cardiac Center of Ethiopia.
Insights
Local surgeons in Ethiopia successfully performed pediatric cardiac surgeries for congenital heart diseases (CHD), achieving acceptable 30-day mortality rates. This demonstrates that complex heart surgeries are feasible in developing countries with limited resources.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Global Health
Background:
- Diagnosis of congenital heart diseases (CHD) is increasing in developing nations due to improved echocardiography access.
- Pediatric cardiac surgery access remains limited, often relying on international surgical campaigns.
- Ethiopia's investment in training local surgeons aims to enhance care for children with CHD.
Purpose of the Study:
- To evaluate the experience and outcomes of pediatric congenital heart disease surgery performed by local surgical teams in Ethiopia.
- To assess the feasibility and safety of cardiac surgery for CHD in a resource-limited setting.
Main Methods:
- A retrospective cohort study was conducted at a pediatric cardiac center in Addis Ababa, Ethiopia.
- Included patients under 18 with congenital or acquired heart disease who underwent surgery.
- Primary outcomes measured were in-hospital mortality, 30-day mortality, and complication rates.
Main Results:
- A total of 76 children underwent surgery, with 95% diagnosed with congenital heart diseases (CHDs).
- Common CHDs included Patent Ductus Arteriosus (PDA), Ventricular Septal Defect (VSD), and Atrial Septal Defect (ASD).
- In-hospital and operative mortality were both 2.6%, with no 30-day mortality post-discharge.
Conclusions:
- Local surgical teams successfully treated various cardiac lesions, with PDA and VSD repairs being most frequent.
- The study demonstrates that congenital and acquired heart diseases can be operated on in developing countries with favorable outcomes, even with limited resources.
- The 30-day mortality rate was within acceptable limits, highlighting the potential for improved pediatric cardiac care locally.
Background:
In developing countries, the diagnosis of congenital heart diseases (CHD) is growing as the availability of echocardiography is increasing with most diagnoses made after birth. However, the access to pediatric surgery is still low and is mainly done by global surgical campaigns rather than local surgeons. Ethiopia has trained its local surgeons, and this is expected to improve the care of children with CHD. We aimed to evaluate the experience of local pediatric CHD surgery and its outcome in a single-center in Ethiopia.
Methods:
A hospital-based retrospective cohort study was done by including all patients with CHD and acquired heart disease in patients under the age of 18 operated at children's cardiac center in Addis Ababa Ethiopia. We set in-hospital mortality, 30-day mortality, and the prevalence of complications including major complications after cardiac surgery as the primary outcomes.
Results:
A total of 76 children were operated. The mean age at the time of diagnosis and surgery was 4 (±5) and 7 (±5) years, respectively. Forty-one (54%) were female. Ninety five percent of the 76 operated children were with the diagnoses of congenital heart diseases while the rest (5%) with acquired heart disease. Of those with congenital heart disease, Patent ductus arteriosus (PDA) accounted for (33.3%), Ventricular septal defect (VSD) for 29.5% and Atrial Septal Defect (ASD) for 10% and Tetralogy of Fallot (TOF) for 5%. According to the RACS-1 category, 26 (35.1%) were in category 1, 33 (44.6%) were in category 2, 15 (20.3%) were in category 3 and none of the children were in category 4 and 5. In-hospital mortality was 2.6% whereas there was no patient who died within 30 days after discharge. Operative mortality was 2.6%.
Conclusions:
Various types of lesions were treated in the hands of the local teams with VSD and PDA ligations as the commonest of all. The 30day mortality was within acceptable range and this outcome shows congenital and acquired heart diseases can be operated on in developing countries with good outcome despite the limited resources.
