# Challenges to Open-Heart Surgery in Sub-Saharan Africa: A Narrative Review

## TL;DR

This paper reviews the challenges of open-heart surgery in Sub-Saharan Africa and suggests ways to improve access and sustainability.

## Contribution

The paper systematically analyzes challenges and proposes a multifactorial approach to expand open-heart surgery in Africa.

## Key findings

- Open-heart surgery has faced significant development challenges in Africa despite early successes.
- Key areas for improvement include training, resource allocation, and capacity building.
- A multifactorial approach is proposed to ensure equitable access to cardiac surgery.

## Abstract

The rising cardiovascular disease burden in Africa necessitates a strengthened
healthcare system including enhanced access to cardiac surgery, the definitive
treatment for several surgical cardiovascular diseases. Though open-heart
surgery, the most invasive type of cardiac surgery, was already possible in
Africa over five decades ago, with pioneering surgeons performing atrial septal
defect repairs via surface cooling in Ghana as early as 1964, its development
across the continent has been hindered by significant challenges. This study
highlights the challenges faced by both established and nascent open-heart
surgery programs across Africa. We further identify key areas for sustaining and
expanding open-heart surgery programs, including robust training for surgeons
and support staff, resource allocation, and enhanced capacity building. By
systematically analyzing the landscape of open-heart surgery in Africa, this
paper proposes a multifactorial approach to overcome these limitations and
ensure equitable access to this life-saving intervention for a vastly
underserved population.