Open-heart surgery in a developing country - Jamaica - abstract

ABSTRACT

Open-heart surgery, using the Heart Lung machine, was first performed on May 6, 1953. Fifteen years later, the first open-heart surgery operation was performed at the University of the West Indies. Since then, just under 700 cases have been done. There has been a varying number of cases performed each year, ranging from 53 cases in the best year to one in the worst year. Despite the long tradition, we still continue to get the sort of publicity in daily newspaper articles "Young beautician needs heart surgery" which appeared during the week of June 14-10, 1993 and the most recent article "Open-heart surgery here soon" appearing in the Gleaner Publication of Sunday, July 11, 1993. Open-heart surgery, in a developing country such as Jamaica, is handicapped by late disease, inadequate investigation, lack of equipment and personnel shortage. At present, valve surgery is the main operation performed on the basis of clinical and echocardiographic findings. Congenital conditions are done, such as atrial septal defects and ventricular septal defects in older children. With the refurbishing of the catheterization laboratory to be completed shortly, the number of cases awaiting surgery will increase. We will be faced with a large patient population requiring surgery, with inadequate resources to meet the demand. Jamaica, like all developing countries, is faced with the dilemna of providing expensive but necessary surgery for its population (AU)