Establishing Pediatric Cardiac Surgery Unit in Underprivileged Area. An Audit of First 100 Cases & Challenges Faced: Pediatric Cardiac Surgery Unit in Underprivileged Area

Iqbal Hussain Pathan; Jai  Parkash; Naresh  Kumar; Muhammad  Farhan Khan; Naveed  Nek

doi:10.54393/pjhs.v3i05.207

Authors

Iqbal Hussain Pathan Department of Cardiac Surgery, Gambat Institute of Medical Sciences(GIMS), Sindh, Pakistan
Jai Parkash Department of Anesthesia, Gambat Institute of Medical Sciences (GIMS), Sindh, Pakistan
Naresh Kumar Department of Pediatric Cardiac Surgery, Gambat Institute of Medical Sciences(GIMS), Sindh, Pakistan
Muhammad Farhan Khan Department of Cardiac Surgery, Gambat Institute of Medical Sciences(GIMS), Sindh, Pakistan
Naveed Nek Department of Cardiac Surgery, Gambat Institute of Medical Sciences(GIMS), Sindh, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v3i05.207

Keywords:

Cardiac Surgery, Pediatric, Congenital, Heart Defects, Underprivileged

Abstract

There is significant global improvement has been observed in declining of under 5-year mortality from 93 deaths per 1,000 births in 1990 to 39 in 2017 (58%). Nevertheless, congenital anomalies predominantly cardiac are still leading cause of under five-year-old mortality. Objective: The aim of this audit was to present our experiences of first hundred cases of congenital heart defects surgeries along with the challenges faced during the establishment of new pediatric cardiac surgery center in underprivileged area. Methods: This was an audit of the first 100 cardiac surgeries performed for congenital heart defects at Gambat Institute of Medical Science from 15- 3- 2021 to1-10-2022. During the period challenges other then related with surgical interventions; more than an investment of money but political, cultural, and social faced. Results: The mean age was 9+/-6.5 years, with female predominance of 57. Sever pulmonary hypertension was present in 6 patients. The majority of our patients were from RACHS1 score category 1. Out of 100 patient open heart surgeries were 89(89%) and close heart were 11(11%). We have single mortality of patient underwent Tetralogy of Fallot correction developed massive stroke and expired at 5th postoperative day. Three patients were re explored for bleeding while one required emergency reopening in PICU for cardiac arrest. Post clamp removal arrhythmias were observed in 7(7%) patients. We received three patients in emergency from Pediatric cardiology post intervention including device embolization, device malposition and acute Mitral regurgitation post intervention. Conclusions: Providing Pediatric cardiac surgery services to the children of remote and socioeconomically deprived area is a greatly rewarding. It has many challenges other than providing direct patient care.

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