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Setting Up an Open Heart Surgical Program in a Developing Country

Austria

The first 300 words of the full text of this article appear below.

In the Art of War, Sun Tzu accented on knowing the terrain. To set up an open heart surgical program in the developing world, one has to start with the same principles.

THE PLACE

The type of hospital will influence the funding and priorities, and thus the mechanics and planning of setting up. The required facilities and amount of investment will also differ according to the nature of the open heart surgical (OHS) center (stand-alone, part of a heart center, unit of a franchise, or department in a general hospital). The geography and economics of the region, size of the population, state of the infrastructure, and communications facilities may be critical in the initial phase. If a new building is planned, it is better to be involved from the beginning and avoid the mistakes of many famous centers in the West, whose current incarnation is the result of local compromises. Try to have operating room (OR) space of at least 8 x 10 m plus anterooms for pump and patient preparation. If initial financial outlay is restricted, plan in a modular manner so that additional features can be added at a later time. If an old OR is refurbished for cardiac surgery, ensure enhanced power supply.¹ Similarly, the intensive care unit (ICU) should be next to the OR to minimize transit time and avoid too much interaction with visitors or attendants, who are perpetually present in developing countries, another cultural difference from the West. Avoid Western hospital architecture of bygone eras, such as ICU towers. Try to have each ICU segment of 6 beds with adequate space around the bed (approximately 18 m²), including one isolation bed.² It is advisable to acquire information on contemporary ergonomics of OR and ICU planning.

THE TEAM

A skeleton team requires 1 surgeon, 2 assistants, 2 nurses . . . [Full Text of this Article]

This article has been cited by other articles:

				A. T. Pezzella Open heart surgery in a developing country. Asian Cardiovasc Thorac Ann, August 1, 2006; 14(4): 355 - 356. [Full Text] [PDF]