Operation Open Heart in PNG, 1993–2006

Tefuarani, N.; Vince, J.; Hawker, R.; Nunn, G.; Lee, R.; Crawford, M.; Kevau, I.H.

doi:10.1016/j.hlc.2007.05.013

« Previous Next »Heart, Lung and Circulation
Volume 16, Issue 5 , Pages 373-377, October 2007

Operation Open Heart in PNG, 1993–2006

N. Tefuarani, DCH, MMed, PhD
- Clinical Sciences Division, School of Medicine and Health Sciences, University, of Papua New Guinea, P.O. Box 5623, Boroko, National Capital District, Papua New Guinea
- Corresponding author. Fax: +675 3250809.
J. Vince, FRCP(Ed), MD
- Clinical Sciences Division, School of Medicine and Health Sciences, University, of Papua New Guinea, P.O. Box 5623, Boroko, National Capital District, Papua New Guinea
R. Hawker, FRACP
- Adolph Basser Cardiac Institute, Royal Alexandra Hospital for Children, Westmead, New South Wales, Australia
G. Nunn, FRACS
- Adolph Basser Cardiac Institute, Royal Alexandra Hospital for Children, Westmead, New South Wales, Australia
R. Lee, RN
- Seventh Day Adventist Hospital, Sydney, New South Wales, Australia
M. Crawford, FANZCA
- Prince of Wales Children's Hospital, Sydney, New South Wales, Australia
I.H. Kevau, FRACP, PhD
- Clinical Sciences Division, School of Medicine and Health Sciences, University, of Papua New Guinea, P.O. Box 5623, Boroko, National Capital District, Papua New Guinea

Objective

To report on the ‘Operation Open Heart’ (OOH) cardiac surgical program in Papua New Guinea (PNG). To document the short-term surgical outcome, the experience gained and the skill transfer from the visiting team members to their PNG counterparts.

Methodology

Analysis of the database compiled from the records of the patients who were operated on by the visiting cardiothoracic surgical team.

Results

Four hundred and seventy patients from all regions of the country received operations. Three hundred and thirty seven (72%) were children less than 12 years of age, 39 (8%) were between 12 and 18 years of age and 263 (56%) were females. One hundred and eighty five (40%) patients had open heart procedures. Complications were unremarkable and the short-term mortality was 1.9%. Clinical skills were transferred to, and experience was gained by national anaesthetists, surgeons, paediatricians, physicians and nurses from intensive and full nursing care units and the operating theatre.

Conclusions

The program not only achieved a higher annual operation rate than previous programs but also had a lower mortality rate. It achieved its objective of service delivery and, to a considerable extent, its objective of skill transfer. There now is an established and active group of PNG doctors and nurses with the skills, experience and confidence to perform patent ductus repair safely and efficiently. The program is cheaper than its predecessors, and is less disruptive for parents, patients and families.

Keywords: Congenital cardiac surgery, Developing world