The Impact of International Missions in Provision of Cardiac Services and Skill Transfer in Respect to Coronary Artery Bypass Grafting at Jakaya Kikwete Cardiac Institute — Tanzania

Abstract

OBJECTIVE: To assess how efficient the local team attained skills are after several visits made by international missions in respect to number of coronary artery bypass grafting surgery performed and the overall patient outcome. METHODS: This was a retrospective study that included all patients who were operated on at the center after being diagnosed with chronic coronary artery disease from May 2016 to December 2023. Patients' demographic data were retrieved from patients' files coupled with theatre record file, entered into a structured questionnaire, and then, in a statistical program. RESULTS: A total of 290 patients underwent coronary artery bypass grafting at the center. The international missions performed a total of 159 (54.8%) operations, while the local team operated a total of 131 (45.2%) patients. The study showed significant statistical difference in terms of total operation time (95% confidence interval [CI] = 5.67, 6.01 vs. 95% CI = 6.32, 6.66), aortic cross-clamping time (95% CI = 75.92, 90.00 vs. 95% CI = 111.19, 126.65), and total cardiopulmonary bypass time (95% CI = 115.9, 134.75 vs. 95% CI = 174.52, 201.27) between the international missions and local surgical team, respectively. The mortality rate was higher in patients operated on by the local team (13.7%) than by international missions (8.8%), however there was no statistical difference. CONCLUSION: This study has shown the beneficial advantage of international surgical missions to newly established open-heart centers with advanced facilities and skill-deprived team. International surgical missions have greatly contributed to the progression of the center as they oversee and support the programs.