The State of Open-Heart Surgery in Nigeria: Challenges, Opportunities, and the Way Forward

Nigeria is facing an increasing burden of cardiovascular diseases, creating an urgent need for sustainable open-heart surgery (OHS) services. Despite decades having passed since the first OHS, the country's progress has been inconsistent, with most centers still operating below capacity. In this paper, we reviewed the existing literature to identify the major challenges facing OHS in Nigeria and to highlight potential opportunities and future directions. Data were collected from articles and reports sourced from PubMed and Google Scholar. The search included keywords such as "challenges", "difficulties", "barriers", "open heart surgery", "cardiac surgery", "Nigeria", and "Federal Republic of Nigeria". Articles that discussed barriers, opportunities, and recommendations for improving OHS services were included. The major challenges identified include inadequate infrastructure and equipment, a shortage of skilled personnel, limited funding and affordability, weak systemic policy, low case volume, and poor incentives and retention. Reasonable opportunities lie in fostering international and diaspora collaborations, increasing private sector involvement and partnerships, and leveraging the epidemiological need. Future directions include strengthening cardiac capacity through sustainable financing mechanisms, workforce development, and integration of OHS into national health policies and insurance schemes. Nigeria's OHS services remain fragile but not without promise. By addressing systemic gaps and capitalizing on emerging opportunities, the country can transition from episodic, externally driven cardiac missions to reliable, self-sustaining national OHS programs.