Incidence of CHD is 8/1000 live births. Population of Pakistan - 160 million, birth rate 3%; therefore more than 50,000 children born each year with CHD. Lack of awareness, infra-structure, and experienced health care providers leads to delayed presentation and inadequate management of CHD. Multi-regional collaboration provides opportunities to enhance local expertise with satisfactory results.
OBJECTIVE: To emphasize the importance of collaboration and share the progress of our program.
MATERIAL & METHODS: Collaboration established in phases with several cardiac surgery centers to minimize the learning curve. To evaluate impact of the new program, data on selected variables were prospectively collected for consecutive cardiac surgeries from June 2006 - December 2008.
RESULTS: Phase One was training of personal, procurement of equipment and logistics. Phase Two saw collaboration with Freeman and Birmingham Children's Hospitals - UK, Escort Hospital - India, and Lahore Children's Hospital - Pakistan . Distribution of open heart surgeries (248): ToF 30%, VSD 25%, ASD 15%, Single Ventricle palliation 5%, TGA 3%, TAPVD 5% others 17%. Distribution of closed heart surgeries (82): BTS 45%, PDA 25%, CoA 10%, others 20%. Median age at surgery, 4.6 (1 day to 67) years; weight 14 (0.8 - 80) kg; CICU stay was 1.5 days. Mortality for open heart surgery was 22/248 - 8.8%, and for closed heart surgery 7/82 - 8.5%.
CONCLUSION: Our mortality is comparable to reports from established congenital cardiac surgery centers of the region, confirming that multi-regional collaboration helped achieve favorable results in the early phase of the program.