Crossing borders to meet cardiac surgical needs: A scoping review on patients seeking cardiac surgery abroad.

Abstract

Background: Over 100 countries do not have a local cardiac surgeon, whereas capacity, coverage, or cultural constrains may limit access to cardiac surgical care in-country. This scoping review aims to summarize the current literature of patients seeking cardiac surgical care abroad and determine research gaps for this understudied aspect of global surgical care.

Methods: A scoping review was conducted on patients seeking cardiac surgery outside of their home country using MEDLINE, EMBASE, CINAHL, SCOPUS, WHO Global Index Medicus, and PubMed databases. Relevant articles were descriptively and quantitatively summarized.

Results: Out of a total of 49 articles and 6351 patients, the most common procedures were coronary artery bypass grafts & valve procedures (N ​= ​3948; 62 ​%) and congenital heart disease repairs (N ​= ​2049; 32 ​%). The most prevalent countries of origin were Japan, Nigeria, and the United Arab Emirates. The United States, France, and the United Kingdom were the most common destination countries. Most patients (N ​= ​1483; 23 ​%) sought care abroad due to limited therapeutic options in the home country. Funding sources stemmed comparably from government funding, non-governmental organization funding, and out-of-pocket payments.

Conclusions: The extent of and reasons for individuals traveling abroad for cardiac surgery are poorly described. Localizing cardiac care, while requiring significant resources, may lead to substantial cost savings and improved access to care. Until then, improving access to international travel for cardiac surgery remains an important strategy.