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Revista Brasileira de Cirurgia Cardiovascular
On-line version ISSN 1678-9741
BURGOS-IRAZABAL, Jose et al. Cardiac surgery in a multi-ethnic low volume service: the Caribbean Heart Care Experience. Rev Bras Cir Cardiovasc [online]. 2005, vol.20, n.3, pp. 332-335. ISSN 1678-9741. http://dx.doi.org/10.1590/S0102-76382005000300016.
INTRODUCTION: The Caribbean is a multi-ethnic society, including Caucasian, Afro-Caribbean, East Indians, Asians, Hispanics, European and natives, which has a broad range of living standards. The incidence and types of heart diseases vary significantly amongst these races. We report the surgical experience (adult and paediatric) of a low volume multiethnic population service based on Trinidad and Tobago. METHODS: The Adult Heart Surgery program started in November 1993. The data on a total of 878 cases (629 male, median age 67, range 18-88 years old) is reported. Of these 39.4% were diabetics and 46.5% hypertensive. The procedures performed include coronary artery bypass grafting, valve repair and replacement, and major aortic surgery including emergency dissection. The paediatric heart surgery program started in Sept 1998 and a total of 279 operations have been performed (Age range, 2 weeks to 21 years) RESULTS: Adult - Overall mortality was 3.8%. The majority of procedures were CABG (82.3%) with an overall mortality of 2.8% (0% in 2004). Off pump CABG accounts for 43% of the total procedures (71.2% in 2004). Aortic valve surgery was carried out in 49 patients and mitral valve replacement/ repair in 96 either with or without CABG. Paediatric - The majority of the procedures were VSD 111, ASD 57, TOF 23, and 88 others (including A-V canal, BT shunt, aorta coarctation) with an overall mortality of 1.5%. CONCLUSION: Heart surgery in a multiethnic low volume service can be performed with excellent results comparable to international standards for adults and paediatrics.
Keywords : Cardiac surgical procedures; Hospitals, statistics & numerical data; Myocardial revascularization; Extracorporeal circulation.