Know thy neighbors: The status of cardiac surgery in the South Asian countries around India

Hosain, Nazmul; Amin, Farzana; Rehman, Somaiya; Koirala, Bhagawan

doi:10.1016/j.ihj.2017.09.219

Cited by 20 publications

(24 citation statements)

References 9 publications

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“…Each year, approximately 150,000 patients undergo cardiac surgeries and 30% is the valve surgeries including both aortic and mitral valve replacement in India [ 1 ]. Compared to western populations, Indian patients indicated for SAVR tend to be younger, have a higher incidence of valve disease due to rheumatic fever and require implantation of smaller valve sizes (predominately 19 mm and 21 mm valves) [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

Early hemodynamic performance of the Trifecta™ surgical bioprosthesis aortic valve in Indian patient population: 12 month outcomes of the EVEREST post-market study

Mannam¹,

Mishra

Modi

et al. 2018

J Cardiothorac Surg

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BackgroundIndian patients undergoing surgical aortic valve replacement (SAVR) differ from western populations with respect to aortic annulus size and valve disease morphology. The purpose of this post-market, non-randomized observational study was to evaluate the early hemodynamic performance of the Trifecta™ bioprosthesis (Abbott, previously St. Jude Medical, Minneapolis, US) in an Indian patient population.MethodsFrom January 2014 to September 2015, 100 patients (mean age 64.4 ± 7.1 years, 62% male) undergoing SAVR for valve disease (68% stenosis, 7% insufficiency, 25% mixed pathology) were enrolled across 10 centers in India. Patients implanted with a 19–27 mm Trifecta™ valve were eligible to participate and were prospectively followed for 12-months post-implantation. Echocardiographic hemodynamic performance was evaluated at pre-implant, pre-discharge and at 12-months by an independent core laboratory. Adverse events were adjudicated by the study sponsor. Functional status at 12-months was assessed according to NYHA classification. Continuous data was summarized using descriptive statistics (mean &standard deviation,) and categorical data was summarized using frequencies and percentages.ResultNinety patients (mean age 64.5, 62.2% male) completed the 12-month follow up. Significant improvements in hemodynamic valve performance were reported in 81 patients with available echocardiographic data at 12 months. Compared to baseline at 12-month follow up visit, mean effective orifice area increased from 0.75cm2 to 1.61cm2 (p < 0.0001), mean pressure gradient reduced to 10.42 mmHg from 51.47 mmHg (p < 0.0001), cardiac output increased from 4.46 l/min to 4.85 l/min (P 0.9254). Compared to baseline, functional status improved by ≥1 NYHA class in 75% of patients at 12 months (95% Clopper-Pearson (Exact) confidence limit [64.6%, 83.6%]). No instances of early mortality (< 30 days from index procedure) or structural valve dysfunction were reported.ConclusionIn an Indian patient population, implantation of the Trifecta™ bioprosthesis is shown to be safe and associated with favorable early hemodynamic performance and improved functional status at 12 months.Trial registrationThe clinical study has been registered under Clinical Trial Registry-India (http://www.ctri.nic.in) and registration number is CTRI/2014/02/004434 registered on 25 February 2014 retrospectively registered.

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Section: Introductionmentioning

confidence: 99%

Early hemodynamic performance of the Trifecta™ surgical bioprosthesis aortic valve in Indian patient population: 12 month outcomes of the EVEREST post-market study

Mannam¹,

Mishra

Modi

et al. 2018

J Cardiothorac Surg

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“…eight government hospitals, one semi-government hospital and eight private hospitals. Hosain et al compared the patterns of cardiac surgery in Southern Asia in 2016 and found that 5500 cardiac operations had been done in Sri Lanka, amounting to 265 operations/ million population [7].…”

Section: Discussionmentioning

confidence: 99%

The workload, outcome and waiting time of cardiothoracic operations: a single unit study in Sri Lanka

Harischandra¹,

Kannagoda²,

Sewwandi

et al. 2020

Sri Lanka j Surg

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Introduction Heart disease is the commonest cause of death worldwide. Its surgical treatment is expensive, and resources are limited. Although there is general concern regarding the work of cardiothoracic units in Sri Lanka, there is very little scientific data regarding it. Our objective was to establish the workload, outcome and waiting time of cardiothoracic operations in a single unit in Sri Lanka. Methods Prospectively entered data from the clinic register and operation logbooks from August 2010 to March 2020 were reviewed retrospectively and collected on data extraction sheets. The data was entered onto a Microsoft EXCEL database and analyzed using SPSS [Statistical Package for Social Sciences]. Results In 1100 patients, 759 [69%] were males and 341[31%], females; The mean age was 50.8 years [1 day-77 years]. Coronary artery bypass grafting [CABG] was the commonest operation [573;52.1%].

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“…Although cardiac surgery had been performed in Nepal since 1965, it was done with the leadership of international surgeons visiting from Australia and USA. 15 Nepalese surgeons were participating as collaborator and assistants to the visitors, until Dr. Bagwan Koirala lead an all Nepalese team and performed the first successful ASD closure in 1997. It was then possible to imagine that children with heart Nepalese Heart Journal 2018; Vol 15(2), 1-2 Editorial @Nepalese Heart Journal.…”

Section: Poonam Sharmamentioning

confidence: 99%

Pioneers and champions for the little hearts: A history of pediatric cardiology in Nepal

Sharma¹

2018

Nepalese Heart J.

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Heart disease in a child requires complex set of expertise as physiology and challenges presented in pediatric cardiology are much different from adult cardiology. In preclinical era of renaissance, children and adults were examined by the same physician. At the outset of 20th century, the need for a special center for children with heart disease was identified as several authors began to add specific sections devoted to congenital heart disease in books of anatomy and pediatrics. A major milestone was reached when Helen Taussig, in charge of cardiac clinic in Harriet Lane Hospital, Baltimore, USA, established pediatric cardiology center for the first time. Pediatric cardiology gained further prominence in 1938 when Robert Gross successfully ligated the patent ductus arteriosus in a seven year old girl. The first successful creation of systemic to pulmonary shunt by Blalock and Taussig in 1944 boldly introduced surgical interventions. The field of pediatric cardiology has been making remarkable developments, with dramatic improvements in diagnostic tools, and with cardiac surgeons constantly pushing the envelope, culminating in being first subspecialty board of pediatrics in USA in 1961. These developments have changed the outlook of cardiac diseases in children and instilled hope for cure in previously untreatable disorders. Interestingly, advances made in pediatric cardiology have provided

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Know thy neighbors: The status of cardiac surgery in the South Asian countries around India

Cited by 20 publications

References 9 publications

Early hemodynamic performance of the Trifecta™ surgical bioprosthesis aortic valve in Indian patient population: 12 month outcomes of the EVEREST post-market study

Early hemodynamic performance of the Trifecta™ surgical bioprosthesis aortic valve in Indian patient population: 12 month outcomes of the EVEREST post-market study

The workload, outcome and waiting time of cardiothoracic operations: a single unit study in Sri Lanka

Pioneers and champions for the little hearts: A history of pediatric cardiology in Nepal

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