Our Summary

This research paper explores the challenges and opportunities of creating a heart surgery program in a remote hospital in Nepal. Each year, over a million heart surgeries are performed worldwide. However, about 93% of the global population, who live in low and middle-income countries, don’t have access to heart surgeries. In Nepal, conditions like rheumatic and congenital heart disease are common, but there are only around 2,500-3,000 heart surgeries performed each year.

The researchers established a heart surgery program in a remote hospital in Nepal and performed 85 open-heart surgeries over 4 years. The average patient was around 38 years old, and mostly male. About 66% of the patients had rheumatic heart disease. After surgery, patients stayed in the intensive care unit for about 2 days and in the hospital for about 8 days. There were no deaths in the hospital.

The researchers concluded that it’s possible to develop a heart surgery program in a remote hospital in a developing country if the government, foreign colleagues, local teams, and non-governmental organizations provide support. Having a regular heart surgery service in remote parts of the country makes it easier for patients to access these services and helps reduce long waiting lists and heavy workloads in the main cardiac centers in the capital city.

FAQs

  1. What challenges and opportunities were explored in the research regarding the creation of a heart surgery program in a remote hospital in Nepal?
  2. What was the outcome of the heart surgery program established by the researchers in the remote hospital in Nepal?
  3. How can a regular heart surgery service in remote parts of a country like Nepal benefit patients and the overall healthcare system?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cardiac surgery is to follow the post-operative care instructions provided by the medical team closely. This may include taking prescribed medications, attending follow-up appointments, and following a healthy diet and exercise plan. It’s important to communicate any concerns or symptoms to your healthcare provider and to ask any questions you may have about your recovery process. By following these guidelines, patients can help ensure a successful outcome after cardiac surgery.

Suitable For

Patients who are typically recommended for cardiac surgery include those with conditions such as coronary artery disease, valve disease, congenital heart defects, and heart failure. Patients who have not responded well to medication or other non-invasive treatments may also be recommended for surgery. Additionally, patients with severe symptoms such as chest pain, shortness of breath, or fatigue, as well as those at high risk for heart attack or sudden cardiac death, may be candidates for cardiac surgery.

Timeline

Before cardiac surgery:

  • Patient is diagnosed with a heart condition that requires surgery
  • Patient undergoes various tests and evaluations to assess their overall health and suitability for surgery
  • Patient meets with the surgeon and medical team to discuss the procedure, risks, and benefits
  • Patient may need to make lifestyle changes or take medications to prepare for surgery
  • Patient may undergo preoperative procedures such as blood tests, imaging scans, and cardiac catheterization

After cardiac surgery:

  • Patient undergoes the surgery, which typically lasts several hours
  • Patient is monitored closely in the intensive care unit immediately after surgery
  • Patient may be on a ventilator to help with breathing and a heart monitor to track heart function
  • Patient gradually transitions to a regular hospital room as they recover
  • Patient works with physical therapists to regain strength and mobility
  • Patient may need to take medications, attend follow-up appointments, and make lifestyle changes to support their recovery and long-term heart health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cardiac surgery include:

  1. What type of heart surgery do I need?
  2. What are the risks and benefits of the surgery?
  3. How experienced is the surgical team in performing this type of surgery?
  4. What is the expected outcome of the surgery?
  5. What is the recovery process like and how long will it take?
  6. What follow-up care will I need after the surgery?
  7. What lifestyle changes will I need to make after the surgery?
  8. What are the potential complications of the surgery?
  9. Are there any alternative treatment options available?
  10. How can I prepare for the surgery mentally and physically?

Reference

Authors: Tiwari KK, Grapsa J, Laudari S, Pazdernik M, Vervoort D. Journal: Perfusion. 2021 Jan;36(1):38-43. doi: 10.1177/0267659120924923. Epub 2020 May 27. PMID: 32460640