The current state of minimally invasive cardiac surgery in Africa: a systematic review and meta-analysis

Abstract

Globally, the utilisation of minimally invasive techniques has become increasingly prevalent. While traditional open-heart procedures still dominate the landscape, a significant portion of cardiac surgeries are now performed minimally invasively. The aim of this study is to provide an insightful overview of the current state of minimally invasive cardiac surgery in Africa. A comprehensive database search was performed on PubMed, African Journal Online, Google Scholar, and Scopus to identify published data reporting on outcomes of minimally invasive cardiac surgery in Africa, from inception till June 2024. We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines to undergo this study. The primary outcomes of interest were in-hospital mortality and overall mortality. Data were pooled together and analysed using a random effect model for meta-analysis with R software. Out of a total of 2309 articles identified, only fourteen papers met our inclusion criteria following deduplication and screening. The four countries with published research include Egypt, South Africa, Tanzania, and Morocco, with a total sample size of 1357 patients. The meta-analysis of the reported outcomes produced a pooled in-hospital mortality prevalence of 1.18%, while the pooled overall mortality prevalence was 2.23%. There was no statistically significant difference in outcomes between the mini sternotomy and the full sternotomy group. The pooled outcomes of minimally invasive cardiac surgery in Africa are comparable to those in other regions. However, there are several socio-economic factors limiting its widespread practice in Africa.