Pioneer human open heart surgery using cardiopulmonary by pass in Uganda.

INTRODUCTION: For the first time in Uganda in April 2007,two open-heart surgeries were done using cardiopulmonary by pass. A multidisciplinary team of largely indigenous Ugandans professionals working in Uganda formed the pioneering team. CONTEXT: Access in cardiac surgery in the developing countries is very limited. The challenges that impede access to adequate and appropriate health care including open-heart surgery are in the least complex and daunting. PATIENT SELECTION: Two 13 and 17 year old males with Secundum Atrial Septal defects were chosen from a long waiting list. The criteria used included no or minimal co morbidity states, patient fitness and available ICU ventilation facilities. PREPARATION: Took an eleven months period, including formulation and adoption of peri and intra operation protocols, training of staff, sourcing of usable and mobilizing the financing. OUTCOMES: The procedure for the two patients was successfully performed. The immediate and short-term postoperative periods were uneventful. At the twelve months review point both patients were leading a normal life. In the months that followed 19 other open-heart procedures were done including two mitral valves replacements. CONCLUSION: This program has greatly enhanced the level of care for the critically ill at this facility. Its sustenance and replication in other centres in the country is essential. Government and development partners' support is critical. The educational value of this program ought to be exploited by health professions students in the country.