ArticleJTCVS open2026
Mapping surgical deserts of cardiovascular training in Latin America: A geospatial and structural analysis.
Article in JTCVS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
10 authors.
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Abstract
Objective: Latin America faces significant disparities in cardiovascular surgery training access. We used a driven geospatial analysis to map surgical deserts-underserved regions to surgical education-and quantified disparities through population-adjusted density metrics and structural variables. Methods: Geospatial analysis mapped all cardiovascular surgery training programs in Latin America. A Composite Access Index (density, travel time, economics, structure) was developed. Hierarchical clustering and regression were used to identify surgical deserts and structural impacts, revealing 3 types: geographic, structural, and economic. Results: A total of 243 cardiovascular surgery programs across 19 Latin American countries provided 454 annual positions. Brazil leads with 170 programs and 280 positions, whereas Guatemala, Honduras, and Nicaragua each have 1 program offering 2 positions. Program density is greatest in Cuba (3.39 positions/million), followed by Uruguay (0.88), Peru (0.73), and Panama (0.67), and lowest in Guatemala (0.11), Argentina (0.13), and Venezuela (0.14). Integrated residency models exist in Cuba, Panama, Peru, and Ecuador; only Brazil, Chile, Mexico, and Venezuela require board examinations. Health spending per capita ranges from $934 in Chile to $35 in Haiti. The Composite Access Index highlights high-access countries (Cuba 1.00, Uruguay 0.95, Chile 0.85), moderate-access (Brazil 0.69, Peru 0.75, Colombia 0.64), and limited-access "surgical deserts" (Bolivia 0.31, Guatemala 0.27). Regression analyses showed no significant effect of structure requirements on access ( Conclusions: This comprehensive mapped study exposes that cardiovascular surgery training in Latin America is highly unequal; surgical deserts persist as a result of limited funding, geographic isolation, and program decentralization, whereas structural requirements minimally influence access.
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