Humanitarian cardiac care in Arequipa, Peru: experiences of a multidisciplinary Canadian cardiovascular team.
BACKGROUND
The prevalence of cardiovascular disease and its associated mortality continue to increase in developing countries despite unparalleled improvements in cardiovascular medicine over the last century. Cardiovascular care in developing nations is often constrained by limited resources, poor access, lack of specialty training and inadequate financial support. Medical volunteerism by experienced health care teams can provide mentorship, medical expertise and health policy advice to local teams and improve cardiovascular patient outcomes.


METHODS
We report our experience from annual successive humanitarian medical missions to Arequipa, Peru, and describe the challenges faced when performing cardiovascular interventions with limited resources.


RESULTS
Over a 2-year period, we performed a total of 15 cardiac repairs in patients with rheumatic, congenital and ischemic heart disease. We assessed and managed 150 patients in an outpatient clinic, including 7 patients at 1-year postoperative follow-up.


CONCLUSIONS
Despite multiple challenges, we were able to help the local team deliver advanced cardiovascular care to many patients with few alternatives and achieve good early and 1-year outcomes. Interdisciplinary education at all levels of cardiac care, including preoperative assessment, intraoperative surgical and anesthetic details, and postoperative critical care management, were major goals for our medical missions.
Division of Cardiac Surgery, Department of Surgery, University of Western Ontario, Lawson Health Research Institute, London, Ont.
Corey
C
Adams
Philipp
P
Kiefer
Kenneth
K
Ryan
David
D
Smith
Greg
G
McCabe
Peter
P
Allen
Kumar
K
Sridhar
Pedro
P
Torres
Michael W A
MW
Chu
D000328:Adult; D000368:Aged; D000533:Altruism; D002170:Canada / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000601:surgery / Q000628:therapy*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008493:Medical Missions / Q000458:organization & administration*; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D010568:Peru; D014838:Volunteers; D055815:Young Adult