Early Experience of Cardiac Surgery in the Maldives

Ranjan Sapkota; Mohamed Shafiu; Dusooma A Razzag; Priyanka B Patil; Haytham M Y Sadoon; Karim M Abouhabiba; Sivaranjani P Vivehananthan; Dipti S Shinde; Mohamed F Moosa; Fathmath A A Sattar; Mani P Gautam; Prateek S Bhadauria; Ali Shafeeq

doi:10.3126/jiom.v41i1.28601

Authors

Ranjan Sapkota AKD Hospital School of Health Sciences, Male’ Maldives
Mohamed Shafiu AKD Hospital School of Health Sciences, Male’ Maldives
Dusooma A Razzag ADK Hospital School of Health Sciences, Male’ Maldives
Priyanka B Patil ADK Hospital School of Health Sciences, Male’ Maldives
Haytham M Y Sadoon ADK Hospital School of Health Sciences, Male’ Maldives
Karim M Abouhabiba ADK Hospital School of Health Sciences, Male’ Maldives
Sivaranjani P Vivehananthan ADK Hospital School of Health Sciences, Male’ Maldives
Dipti S Shinde ADK Hospital School of Health Sciences, Male’ Maldives
Mohamed F Moosa ADK Hospital School of Health Sciences, Male’ Maldives
Fathmath A A Sattar ADK Hospital School of Health Sciences, Male’ Maldives
Mani P Gautam ADK Hospital School of Health Sciences, Male’ Maldives
Prateek S Bhadauria ADK Hospital School of Health Sciences, Male’ Maldives
Ali Shafeeq Indira Gandhi Memorial Hospital, Male’ Maldives

Keywords:

Cardiac surgery, coronary artery bypass, Maldives, valve replacement

Abstract

Introduction:From stitching a heart wound to the current level of sophistication, cardiac surgery has come a long way as a discipline. Heart surgery in South Asia has advanced tremendously; both, quantitatively and qualitatively. This is a report of the first fifteen surgeries done in the Maldives where cardiac surgery has started as an organized program.

Methods: Data on the first fifteen consecutive cardiac surgeries done in our hospital, over a period of 7 months, was analyzed. We briefly describe our usual perioperative management, and the pretext of the beginning of the cardiac surgery program.

Results: Fifteen patients, 13 males, aged 59.9±13.8 years, with a EuroScore of 0.9±0.4%, were operated. Eleven underwent CABG; and four had a valve replacement. Nine out of 11 had TVD, including 6 who had an LMCA disease. The first surgery was an off-pump CABG. The CABG group had a total of 2-5 grafts. Pump and cross-clamp times were 239.6 (± 56.1) min and 154.2 (± 45) min respectively. Five (33.3%) had at least one non-fatal complication. Two (13.2%) required re-exploration for mediastinal bleeding. The length of hospital stay was 16.5 days (±6.9 days). The chest tubes stayed for an average of 4.8 (±0.7) days. There was no in-hospital, 30-day and 90-day mortality recorded.

Conclusion: Cardiac surgery has begun in the Maldives. It is safe and feasible to sustain cardiac surgery program in the country, provided continued national support and international collaboration is ensured.

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