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Are we improving after 10 years of humanitarian paediatric cardiac assistance?

Published online by Cambridge University Press:  13 July 2005

William M. Novick
Affiliation:
Department of Surgery, University of Tennessee-Memphis, United States of America Department of Pediatrics, University of Tennessee-Memphis, United States of America International Children's Heart Foundation, Memphis, Tennessee, United States of America
Gregory L. Stidham
Affiliation:
Department of Pediatrics, University of Tennessee-Memphis, United States of America International Children's Heart Foundation, Memphis, Tennessee, United States of America
Thomas R. Karl
Affiliation:
Division of Pediatric Cardiothoracic Surgery, University of California-San Francisco, United States of America International Children's Heart Foundation, Memphis, Tennessee, United States of America
Karen L. Guillory
Affiliation:
International Children's Heart Foundation, Memphis, Tennessee, United States of America
Visnja Ivanćan
Affiliation:
Department of Surgery; Departments of Cardiac Surgery and Pediatrics, KBC-Zagreb, Rebro University Hospital, Zagreb, Croatia International Children's Heart Foundation, Memphis, Tennessee, United States of America
Ivan Malčić
Affiliation:
Department of Surgery; Departments of Cardiac Surgery and Pediatrics, KBC-Zagreb, Rebro University Hospital, Zagreb, Croatia
Nestor Sandoval
Affiliation:
Department of Cardiac Surgery, Fundacion Abood Shaio, Bogotá, Colombia
Robert W. Reid
Affiliation:
International Children's Heart Foundation, Memphis, Tennessee, United States of America
Vasily V. Lazorishisnets
Affiliation:
Department of Congenital Heart Disease, Kyiv Institute of Cardiovascular Surgery, Kyiv, Ukraine
Matthew C. Davis
Affiliation:
International Children's Heart Foundation, Memphis, Tennessee, United States of America
Victor C. Baum
Affiliation:
Department of Anesthesiology, Pediatrics and the Cardiovascular Research Center, University of Virginia, United States of America
Thomas G. Di Sessa
Affiliation:
Department of Pediatrics, University of Kentucky, United States of America International Children's Heart Foundation, Memphis, Tennessee, United States of America

Abstract

Background: Paediatric cardiovascular services are frequently absent or poorly developed in many countries around the world. Our foundation made 83 trips in support of cardiovascular services between April 1993 and March 2003 to help alleviate this problem. In this study, we present an analysis of our results over these period of 10 years. Methods: We performed a review of all available records relating to the trips, including patient databases, audited financial statements, donated product inventory lists, lists of team members, and follow-up data from the host sites concerning the state of the patients treated. Results: We made 83 trips to 14 countries, 40 of these being in Central Europe, 5 in Eastern Europe, 10 in Caribbean, and Central America, 18 in South America, 9 in Asia, and 1 in the Middle East. In the first 5 years, we made 23, as opposed to 60 in the second 5 years, this difference being significant (p less than 0.01). The total number of primary operations performed over 10 years was 1,580. The number of procedures performed yearly increased over the two intervals from 97.0 plus or minus 32.7 to 219.0 plus or minus 41.7, p less than 0.002. The probability of survival between the periods increased from 84.6 to 93.3 per cent, and this was also significantly different (p less than 0.001). Overall, the rate of survival for the period of 10 years was 90.5 per cent. Moreover, the value of services donated to support each trip also differed significantly, decreasing from 105,900 dollars plus or minus 14,581 dollars for the first period to 54,617 dollars plus or minus 11,425 dollars for the second period (p less than 0.001). Conclusions: Improving paediatric cardiac services in under-served countries requires significant financial and personnel commitments, but can produce reasonable outcomes.

Type
Original Article
Copyright
© 2005 Cambridge University Press

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