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Cited by 287Global Health and SurgeryHistory of Medical PracticeCardiac and Coronary Surgery Techniques

Global cardiac surgery: Access to cardiac surgical care around the world

Open access
Vervoort, Dominique, Meuris, Bart, Meyns, Bart, Verbrugghe, Peter·2020·The Journal of Thoracic and Cardiovascular Surgery
DOI 10.1016/j.jtcvs.2019.04.039
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Abstract

Objective Cardiovascular disease is the leading cause of death worldwide, responsible for 17.5 million deaths every year, of which 80% occur in low- and middle-income countries. Some 75% of the world does not have access to cardiac surgery when needed because of lack of infrastructure, human resources, and financial coverage. This study aims to map access to cardiac surgery around the world. Methods A scoping review was done on access to cardiac surgery for an undifferentiated population. Workforce data were collected from the Cardiothoracic Surgery Network database and used to calculate numbers and ratios of adult and pediatric cardiac surgeons to population. Results A total of 12,180 adult cardiac surgeons and 3858 pediatric cardiac surgeons were listed in the Cardiothoracic Surgery Network in August 2017, equaling 1.64 (0-181.82) adult cardiac surgeons and 0.52 (0-25.97) pediatric cardiac surgeons per million population globally. Large disparities existed between regions, ranging from 0.12 adult cardiac surgeons and 0.08 pediatric cardiac surgeons per million population (sub-Saharan Africa) to 11.12 adult cardiac surgeons and 2.08 pediatric cardiac surgeons (North America). Low-income countries possessed 0.04 adult cardiac surgeons and 0.03 pediatric cardiac surgeons per million population, compared with 7.15 adult cardiac surgeons and 1.67 pediatric cardiac surgeons in high-income countries. Conclusions This study maps the current global state of access to cardiac surgery. Disparities exist between and within world regions, with a positive correlation between a nation's economic status and access to cardiac surgery. Low early mortality rates in low-resource settings suggest the possibility of high-quality cardiac surgery in low- and middle-income countries. There is the need to increase human and physical resources, while focusing on safety, quality, and efficiency to improve access to cardiac surgery for the 4.5 billion people without.

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  • Approximately 2.5 million people in low-income countries are in need of cardiac surgery.

    “As a result, there are approximately 2.5 million people in need of cardiac surgery in low-income countries.14”

    From Tetralogy of Fallot in Low- and Middle-Income Countries (2024) · cites this paper as [14]

  • Many countries, particularly in Africa, do not have a paediatric cardiac surgery centre despite populations sometimes exceeding 70 million.

    “Globally, a recent study using the Cardiothoracic Surgery Network data estimated that many countries, particularly in Africa, do not have a paediatric cardiac surgery centre despite that their populations sometimes exceed 70 million.14”

    From Tetralogy of Fallot in Low- and Middle-Income Countries (2024) · cites this paper as [14]

  • There are major disparities in the distribution of congenital heart surgeons, with 0.08 surgeons per million in sub-Saharan Africa versus 2.08 surgeons per million in North America.

    “There are also major disparities in the distribution of congenital heart surgeons, with a rate of 0.08 surgeons per million vs 2.08 surgeons per million inhabitants in sub-Saharan Africa and in North America, respectively (Fig. 1).”

    From Tetralogy of Fallot in Low- and Middle-Income Countries (2024) · cites this paper as [14]

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Authors
Vervoort, D., Meuris, B., Meyns, B., & Verbrugghe, P.
Affiliations
  • Harvard University (US)
  • Universitair Ziekenhuis Leuven (BE)
Corresponding author
Vervoort, Dominique
ORCID
Venue
The Journal of Thoracic and Cardiovascular Surgery
Publisher
Elsevier BV
Published
2020-03
Volume
159
Issue
3
Pages
987-996.e6
ISSN
0022-5223 (ISSN-L)
DOI
10.1016/j.jtcvs.2019.04.039
OpenAlex
W2940834286
Cited by
287
References
45
Citations by year
2026: 39 · 2025: 49 · 2024: 55 · 2023: 46 · 2022: 38 · 2021: 33 · 2020: 22 · 2019: 5
FWCI
3.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Lirias (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
  • Health Sciences › Medicine › Neurology › History of Medical Practice
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Keywords
access to cardiac surgery, cardiac surgeons, pediatric cardiac surgery, low- and middle-income countries, global health disparities, cardiovascular mortality, surgical workforce, regional disparities, sub-Saharan Africa
MeSH terms
Developing Countries, Health Services Accessibility, Health Services Needs and Demand, Cardiac Surgical Procedures, Humans, Specialization, Global Health, Health Care Costs, Quality Indicators, Health Care, Needs Assessment, Healthcare Disparities, Surgeons

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