Pediatric Cardiac Surgery in Low and Middle Income Countries: Barriers and Gateways

Congenital heart defects are the most frequent congenital malformation, affecting one in hundred live births. 70% will require treatment in the first year of life, but over 90% of cases in low and middle-income countries (LMICs) receive no treatment or suboptimal treatment. As a result, congenital heart defects are responsible for 66% of preventable deaths due to congenital malformations in LMICs.

We know first hand of the multiple forces at work in the health systems of low and middle income countries affecting the development of pediatric cardiac surgery programs. But we also know how successful local teams of specialists have been in implementing solutions to those obstacles.

We believe a special number dedicated to teams from those countries describing how they have successfully managed to find ways to change the natural history of congenital heart disease in their own limited resources setting would be of great interest to a wide audience of pediatric cardiac surgeons, cardiologists, anesthesiologists and intensivists from low and middle income countries.

This Research Topic will explore pediatric cardiac surgery programs in LMICs, and where these countries are in the process towards fully independent, high volume, high risk cases, and the main obstacles preventing them for reaching this goal.

Contributors may refer to the improvements in the diagnosis or results for a particular congenital malformation, special monitoring country-wide programs to detect congenital heart patients, improvements in the governmental, private or mixed funding making those improvements feasible, or the transformation of a particular service from early stages to full independent performance of clinical services through collaborations and partnerships with NGOs or Western based centers. In summary, contributors should present successful measures that could be implemented by the readership of colleagues in countries with similar limitations.