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

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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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“3,4,6,7,9 Challenges specific to resource-limited settings”

Authors: Vervoort, D., Meuris, B., Meyns, B., & Verbrugghe, P.
Affiliations: Harvard University (US)
Universitair Ziekenhuis Leuven (BE)
Corresponding author: Vervoort, Dominique
ORCID: Vervoort, Dominique
Meuris, Bart
Meyns, Bart
Verbrugghe, Peter
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
FWCI: 3.96
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 730 d)
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 › Surgery › 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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Global cardiac surgery: Access to cardiac surgical care around the world

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