The State of Cardiac Surgery in Pakistan Today

Abstract

Cardiac surgeiy has made significant advances in Pakistan since its humble beginning in Karachi and Pindi over two decades ago. There are at present in Pakistan twelve cardiac surgeons and eight hospitals where cardiac surgery of some sort is being done at least inter mittently. However, only the government run institutions in Karachi, Pindi and Lahore are doing regular work in some volume. Rheumatic heart disease surge,y mainly involves a large number of valvotomies usually of thc mitral valve and in the remaining cases a valve replacement or repair is done. As this is the most common type of surgery done in Pakistan, there has developed a significant expertise in this area in our surgical teams. The mortality of valvular surgery in Pakistan is quite comparable to results in good centers of the world.In the area of coronary bypass surgery there is a lot ofpressure to increase the small volume being done, This type of surgery was started only a few years ago. The total experience is still small. The large initial morbidity and mortality is much less now than before, but, is still higher than in the advanced centers of the world. To sum it up, our cardiac surgical teams deseive congratulations for the improvement in their surgical skills and results and need our encouragement so that one day they may come up to internationally acceptable results. It is our cardiologists and cardiology departments and institutes that have failed miserably in gathering data necessary to provide the surgical teams with a feed back and short and long term followup and as such are the cause of stagnation and less than ideal performance of the surgical teams. Until this situation is corrected we will remain in the backwaters of cardiology and cardiac surgery and continue to spend crores of this poor country ‘S money without even knowing whether any good is being done our not!