Thorac Cardiovasc Surg 2021; 69(08): 729-732
DOI: 10.1055/s-0040-1721395
Short Communications

Health System Needs to Establish Cardiac Surgery Centers

1   Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
Akash Premkumar
2   Harvard Medical School, Harvard University, Boston, Massachusetts, United States
Hiba Ghandour
3   Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio, United States
Jacques Kpodonu
4   Division of Cardiac Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations
Funding None.


Cardiovascular diseases are the leading cause of mortality worldwide, responsible for nearly 18 million deaths each year. More than 80% of these take place in low- and middle-income countries (LMICs), where access to cardiac surgical services is scarce. Approximately 93% of the LMIC population, or six billion people worldwide, are estimated to lack access to safe, timely, and affordable cardiac surgical care as a result of workforce, infrastructure, financial, and quality barriers. Various models have been proposed and attempted to establish cardiac surgery centers in LMICs; however, only some have been successful in achieving sustainable local services. Here, we describe the workforce, infrastructure, financial, and political needs and considerations from a health systems perspective to establish a cardiac surgery center.

Publication History

Received: 25 July 2020

Accepted: 09 October 2020

Article published online:
09 January 2021

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