1284: OUTCOMES FROM THE GIFT OF LIFE INTERNATIONAL SURGERY REGISTRY

Abstract

Introduction: Of the 1.3 million children born with congenital heart disease annually, over 90% do not have access to cardiac care. Since 2020, Gift of Life International (GOLI) has collaborated with CEDIMAT Hospital in the Dominican Republic to perform pediatric cardiac surgery. With limited access to care and delayed surgical repair, this population is data rich in epidemiology, natural history, and clinical management strategies. There is limited research evaluating the outcomes of pediatric cardiac surgery in this middle-income country. Prior studies have raised concerns of limited published data and the need for an international database with better accountability and communication between charities being imperative for patient safety. Since 2021, GOLI has been collecting data for internal quality review. We hope this study will serve as a beacon for charitable organizations to provide quality cardiac surgery to children with limited access. Methods: Combined retrospective and prospective observational analysis of the GOLI Surgical Registry was performed. The registry was developed by GOLI team members, using definitions shared by the PC4 and STS databases for generalizability. All patients who underwent cardiac surgery with the GOLI team at CEDIMAT Hospital since March 2021 to date were included. Results: 55 subjects were identified. They were predominantly Hispanic females (55%) with a mean age at diagnosis of 1.9 years, and mean age at repair of 3.5 years. Primary diagnosis included ASD (9%), VSD (32%), PDA (11%), AV Canal (9%), Tetralogy of Fallot (16%), Single Ventricle (13%), and Coarctation (7%). Most common intraoperative complications were bleeding requiring transfusion (14%) and multiple CPB runs (7%). ICU complications included arrhythmias (17%), cardiac arrest (7%), LCOS (5%), and effusions requiring chest tube (5%). Mean duration of intubation was 17.8 hours with 2 reintubations. Mortality was 7.1%. Conclusions: Globally, there is limited access to cardiac care for children with CHD. While many organizations have tried to close this gap, there is little published data on the surgical outcomes in low/middle-income countries. This study demonstrates that emerging countries can safely perform cardiac surgery and track quality metrics in children with congenital heart disease.