Evidence map›Paper›PMID 38242971›Full record

ArticlePediatric cardiology2025

Establishing a High-Quality Pediatric Cardiac Surgery Program in Post-Conflict Regions: A Model for Limited Resource Countries.

Tammam Youssef, Fouad Bitar, Hassanain Alogla, Maya El Khoury, Jihan Moukhaiber, Farah Alamin, Bassam AlHareth, Cristoveanu Catalin Gabriel, Rana Youssef, Labib Abouzahr and 2 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 3 countries.

Tammam Youssef, San Donato Milanese-Milano, Italy.
Fouad BitarChildren's Heart Center, Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
Hassanain AloglaCardiac Surgery Program at Imam Al Hassan Hospital, Karbala, Iraq.
Maya El KhouryChildren's Heart Center, Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
Jihan MoukhaiberChildren's Heart Center, Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
Farah AlaminChildren's Heart Center, Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
Bassam AlHarethMarie Curie Children's Hospital Bucharest, Bucharest, Romania.
Cristoveanu Catalin GabrielMarie Curie Children's Hospital Bucharest, Bucharest, Romania.
Rana YoussefUniversity Tichreen Hospital, Latakia, Syria.
Labib AbouzahrLabib Medical Center, Sidon, Lebanon.
Zahi Abdul SaterCollege of Public Health, Phoenicia University, Mazraat El Daoudiyeh, Lebanon.
Fadi BitarChildren's Heart Center, Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon. fbitar@aub.edu.lb.
American University of Beirut · LBSpitalului Clinic de Urgență pentru Copii Maria Sklodowska Curie · ROIRCCS Policlinico San Donato · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCongenital Heart Disease stands as a prominent cause of infant mortality, with notable disparities in surgical outcomes evident between high-income and low- to middle-income countries.

objectiveThis study presents a collaborative partnership between a local governmental entity and an international private organization to establish a high-quality Pediatric Cardiac Surgery Program in a post-conflict limited resource country, Iraq.

methodsA descriptive retrospective study analyzed pediatric cardiac surgery procedures performed by a visiting pediatric heart surgery team from October 2021 to October 2022, funded by the Ministry of Health (MOH). We used the STS-EACTS complexity scoring model (STAT) to assess mortality risks associated with surgical procedures.

resultsA total of 144 patients underwent 148 procedures. Infants comprised 58.3% of the patients. The most common anomalies included tetralogy of Fallot, ventricular septal defect, and various single ventricle categories, constituting 76% of the patient cohort. The overall surgical mortality rate was 4.1%, with an observed/expected surgical mortality rate of 1.1 (95% CI 0.5, 2.3). There was no significant difference between our observed surgical mortality in Category 2, 3, and 4 and those expected/reported by the STS-EACTS Database (p = 0.07, p = 0.72, and p = 0.12, respectively). The expenses incurred by the MOH for conducting surgeries in Iraq were lower than the alternative of sending patients abroad for the same procedures.

conclusionThe partnership model between a local public entity committed to infrastructure development and funding and an international private organization delivering clinical and training services can provide the foundation for building sustainable, high-quality in situ programs in upper-middle-income countries.

Indexed as

Cardiac Surgical ProceduresHeart Defects, CongenitalChildChild, PreschoolDeveloping CountriesFemaleHumansInfantInfant, NewbornIraqMaleRetrospective StudiesBuilding in situ programsCongenital heart surgeryGovernmental and private partnership, low- and middle-income countriesLimited resource countryOutcome of pediatric cardiac surgery

Identifiers

PMID38242971
PMCPMC11787184
OpenAlexW4391014876

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.