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Excited to be at the 56th @STS_CTsurgery Annual Meeting (#STS2020) in New Orleans!

In honor of 56 years of the meeting and society, starting tomorrow, I'll be tweeting an overview of #GlobalCardiacSurgery through a 56-tweet tweetorial below. #GlobalSurgery #TSSMN @GlobalCardiac Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink (1/56) #GlobalCardiacSurgery = area for study, research, practice, advocacy .. priority on improving health outcomes & achieving health equity for all .. affected by cardiac surgical conditions or have the need for cardiac surgical care. #STS2020

Ref: academic.oup.com/ejcts/article-… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay (2/56) Traditionally, #GlobalCardiacSurgery has been neglected within #GlobalSurgery. But, SIX BILLION people lack access to cardiac surgical care while CVD = leading cause of death worldwide. #STS2020

Refs: ncbi.nlm.nih.gov/pmc/articles/P…
fac.org.ar/qcvc/llave/c01… ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon (3/56) In 2001, @worldheartfed President Dr. James Cox said: “As thoracic surgeons, we must recognize that we as a specialty have failed the international community, and we should place the task of correcting that failure at the top of our agenda”. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 (4/56) Understandably strong words: North America and Western Europe had 1 cardiac center per 120,000 people, whereas Asia only 1 per 25 MILLION and sub-Saharan Africa only 1 per 38 MILLION. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @SOTASociety (5/56) Now we know more - and it’s still disturbing: where high-income countries rely on 7.15 cardiac surgeons per million population, low-income countries have only 0.04 per million. #GlobalCardiacSurgery #STS2020

Ref: jtcvs.org/article/S0022-… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @SOTASociety @InciSioNGlobal (6/56) Sure, the surgical burden of ischemic heart disease is three times as low in #LMICs. Yet, #RHD affects 33.4 million people across the world, and over 1.3 million children are born with #CHD in LMICs each year. #GlobalCardiacSurgery #STS2020

Ref: sciencedirect.com/science/articl… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @SOTASociety @InciSioNGlobal (7/56) >90% of #CHD cases in LMICs do not receive care they need. Pediatric cardiac surgeons spread few & far between: High-income countries have 9.51 per million children; low-income countries 0.07. Difference: 136 TIMES. #GlobalCardiacSurgery #STS2020

jtcvs.org/article/S0022-… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @SOTASociety @InciSioNGlobal (8/56) Nearly 20 years after Dr. Cox’ Presidential Address, much is still left to do. Example: #Rwanda among most advanced LMICs but #RHD is still left largely untreated: nytimes.com/2018/09/16/hea… #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter (9/56) Commendable NGO efforts help make a change, as @TeamHeartRwanda illustrates in Rwanda & @CHeartLink in India, Vietnam, and Brazil. Governments, however, remain mostly silent on the background. #GlobalCardiacSurgery #STS2020

ncbi.nlm.nih.gov/pmc/articles/P… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs (10/56) In @TCSurgeon, I will be highlighting (in press) the lack of mention of #CTSurgery in existing National Surgical, Obstetric, and Anesthesia Plans (#NSOAPs) and pose a potential way forward - because there is. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @TCSurgeon (11/56) Local #CTSurgery services strengthen entire health systems & care continuum: imaging, ICU, dialysis, referrals, supply chain, financing, etc. - benefitting all health services. #GlobalCardiacSurgery #STS2020

academic.oup.com/ejcts/article-…

(Photo by Piron Guillaume on Unsplash) Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @TCSurgeon (12/56) But beware: single mission trips without capacity-building = pouring water in a bucket with holes. Yes, the bucket needs to be filled, but without closing the gaps, no progress is made. #GlobalCardiacSurgery #STS2020

insights.ovid.com/crossref?an=00… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs (13/56) In a recent @GlobalCardiac poll, #GlobalCardiacSurgery priorities seem clear: lack of funding/high costs and absent political commitment - the latter described above. #STS2020

globalcardiacsurgery.com/2019/12/16/bar… ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs (14/56) Performing #CTSurgery = expensive, but it does not have to be. CABGs in USA often cost over $100,000. CABGs in India and Vietnam often less than $3,000 - congenital heart surgery getting close to that. #GlobalCardiacSurgery #STS2020

ctsnet.org/article/locati… @ctsnetorg Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @ctsnetorg (15/56) Pediatric cardiac surgery can be performed at comparably low costs. As a result, PCS in #LMICs = cost-effective at $171 per DALY averted. #GlobalCardiacSurgery #STS2020

#OpenAccess link: jamanetwork.com/journals/jaman… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @ctsnetorg (16/56) Not surprisingly: children are the future, but hundreds of thousands of children die each year due to #CHD but lack of surgery (under review). Overall, many more die even in high-income countries. #GlobalCardiacSurgery #STS2020

thelancet.com/journals/lanch… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @ctsnetorg (17/56) Operational costs linked with quality, and both linked with volume. Exactly why Narayana Health operates at very low complication rates for $2,000 a piece. How can we model economies of scale in other countries? #GlobalCardiacSurgery #STS2020

bloomberg.com/news/features/… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @ctsnetorg (18/56) Low- & middle-income countries spend up to >10% of health budgets on treatment abroad for cardiac patients. Crazy thought: what if funds were directed towards investing in own #HealthSystem? #GlobalCardiacSurgery #STS2020

imf.org/en/Publication….
researchgate.net/publication/56… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @ctsnetorg (19/56) Let it be clear: nobody expects cardiac centers for every country. But, regional hubs non-existent. E.g., why fly all patients from Africa to India, when multiple high-volume centers are attainable on the continent? #GlobalCardiacSurgery #STS2020

ijhpm.com/article_3633.h… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @ctsnetorg (20/56) Establishing new cardiac programs is a difficult task, as seen in many countries. Nigeria, for example, had/has budding programs across the country -commendable- but faces many struggles despite diversity of models. #GlobalCardiacSurgery #STS2020

cambridge.org/core/journals/… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @ctsnetorg (21/56) Meanwhile, Ghana’s leadership in West Africa led to its early ability to establish a functional, independent center under Dr. Frimpong-Boateng’s leadership, illustrating nuances in processes. #GlobalCardiacSurgery #STS2020

cambridge.org/core/journals/…
panafrican-med-journal.com/content/articl… ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs (22/56) Elsewhere, @TeamHeartRwanda catalyzed/s Rwanda towards its first independent program, Open Heart International did so in Papua New Guinea, etc. #GlobalCardiacSurgery #STS2020

heartlungcirc.org/article/S1443-…
jtcvs.org/article/S0022-… ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs (23/56) The important question: where do future #LMIC cardiac surgeons train? A lot of interest in pursuing specialty careers stemming from the #FutureOfTheOR in LMICs, as shown by @InciSioNGlobal, but only a handful of “local” programs available. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs (24/56) Ghana = training hub for West Africa. Kenya for @cosecsa Region. South Africa, Egypt, India, China train bulk of rest of #LMICs without training programs in sub-Saharan Africa & Southeast Asia - but, # of trainees nowhere near enough. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @cosecsa (25/56) Barriers? Visas, funding, and accreditation. There is no international certification for #CTSurgery, meaning many surgeons are geographically restricted in training and practice. #GlobalCardiacSurgery #STS2020

journals.sagepub.com/doi/full/10.11… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @cosecsa (26/56) Plus, the nuances in skillsets: few CT surgeons trained in North America/Europe (still) know how to handle #RHD, #TB, endomyocardial fibrosis, etc. LMIC-trained less familiar with minimally-invasive techniques. Continuing global divide. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @cosecsa (27/56) Not only clinical skills matter: the global cardiac surgeon needs to understand the political situation, governmental relations, #HealthSystems operations, and surgical supply chain management practices - plus, needs to be an advocate. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @jwleecenter @wjpchs @cosecsa (28/56) In today’s rapidly developing #UHC era, CT surgeons need to get out of their comfort zones -the hospital- and speak up. They're not sitting at the table & as a result, not listened to in health systems strengthening. #GlobalCardiacSurgery #STS2020

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@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen (29/56) And there, we, as a #CTSurgery/#GlobalCardiacSurgery community, can learn from other specialties - similar to @GICSurgery for pediatric surgery, @wfsaorg for anesthesia, and @WFNSHQ for neurosurgery. #STS2020

ncbi.nlm.nih.gov/pmc/articles/P… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @GICSurgery @wfsaorg @WFNSHQ (30/56) As embodied in #GlobalSurgery, collaboration is instrumental to all successes: whether establishing new programs, creating policy plans, or synergizing societal efforts. So, too, should be the inclusion of cardiology voices - and vice versa. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @GICSurgery @wfsaorg @WFNSHQ (31/56) No specialty as cross-cutting as cardiac surgery, beyond OR:

➡️#CHWs: detect #CVD

➡️Surveillance systems: prevent or diagnose #RHD

➡️Referral systems: minimise disease progresion

➡️Longterm cardiology follow-up & anticoagulation clinics

#GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @GICSurgery @wfsaorg (32/56) Without a fully functioning system in place, three delays arise: delays in seeking care, reaching care, and receiving care. But, modern technologies and #digitalhealth can help tackle these delays. #GlobalCardiacSurgery #STS2020 @jacqueskpodonu

researchgate.net/publication/33… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @GICSurgery @wfsaorg @jacqueskpodonu (33/56) Although impetus towards data availability, there's a lack of data illustrating the exact gaps in the first place. We cannot manage what we don’t measure, but what is currently happening in #LMICs? How many surgeries? By who? What outcomes? #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @GICSurgery @wfsaorg @jacqueskpodonu (34/56) Data that *is* available = promising. Early mortality rates after open-heart surgery in Samoa, Fiji, Pakistan, Cambodia, Mozambique, etc. low and comparable to those in high-income countries. #GlobalCardiacSurgery #STS2020

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onlinelibrary.wiley.com/doi/abs/10.111… ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @GICSurgery (35/56) Growing body of congenital heart surgery data available -through @IQICforCHD & @WSPCHSTweet databases- but still only small samples + adult #CTSurgery data not collected in #LMICs. Needed for risk scores & advances. #GlobalCardiacSurgery #STS2020

journals.sagepub.com/doi/full/10.11… Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @GICSurgery @IQICforCHD @WSPCHSTweet (36/56) Data helps w/ understanding of variability between countries + within countries. E.g., in China, 3/4 of cardiac centers perform <200 procedures/year, whereas Shanghai Children’s Medical Center performs >4000 pediatric cardiac surgeries/year. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @pmolinaro2 @DrTylerWallen @GICSurgery @IQICforCHD @WSPCHSTweet (37/56) These disparities remain prominent across #LMICs worldwide. In China, West least access. In Brazil, Northwest least access (under review). In Uzbekistan, Tashkent only (and peripheral) center. In Pacific, Papua New Guinea only option. Etc. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie (38/56) More twinning programs (North-South and, ultimately, South-South partnerships) are needed to develop sustainable services.

E.g., @dukeHHproject in Honduras, @MayoClinic through @CHeartLink and @BostonChildrens through @IQICforCHD in India. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @TurekPedHearts (39/56) Critical to this: capacity-building & continuity. Not in & out, but training local workforce in ultrasonography, nurses in ICU care, biomedical engineers in taking care of equipment, etc. Building up step-by-step (e.g. growing RACHS scores). #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @TurekPedHearts (40/56) All in all, we have to understand the changing global landscape - we cannot miss #GlobalHealth train. In the 20th century, time might not have been ripe. Today, in 2020, it is. Nevertheless, myths underlying #GlobalCardiacSurgery prevail. #STS2020

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@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @TurekPedHearts (41/56) Now we know: #GlobalCardiacSurgery can be scaled, can be done at low costs, can be more cost-effective than existing global public health priorities, can be done safely in #LMICs, and has a role in modern #globalhealth. #STS2020

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@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @TurekPedHearts (42/56) Cardiovascular diseases kill nearly 18 million people every year, affects hundreds of millions of people around the world, and approx. 32% of CVD admissions will require surgical or interventional care at least once. #GlobalCardiacSurgery #STS2020

journals.plos.org/plosone/articl… ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @TurekPedHearts (43/56) Societal leaders, pivotal figures, and #CTSurgery pioneers have called upon the cardiothoracic community to wake up. Over the years, not much happened, but now, momentum is growing. Where do we go from here? #GlobalCardiacSurgery #STS2020 ImageImageImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD (44/56) @GlobalCardiac (globalcardiacsurgery.com) has been developed as a platform to convene #GlobalCardiacSurgery information, #OpenAccess #CTSurgery educational materials, and highlight and learn from success stories. #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD (45/56) The #CapeTownDeclaration on #RHD was released as an inter-societal effort stemming from professional #CTSurgery societies & resulting in the Cardiac Surgery Intersociety Alliance. Pivotal for awareness, but now there is the need to step up. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (46/56) Efforts need to be convened, not fragmented. Foci need to be broad, not too confined. All stakeholders need to be included, not only informed. All voices need to be listened to, not only be represented. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (47/56) Today, social media (#SoMe) and growing connectivity allow for more streamlined, international, and inclusive efforts - to advance the field, but also to educate each other. Dissemination and integration. #GlobalCardiacSurgery #STS2020 #TSSMN Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (48/56) #SoMe enables scholarly dissemination, network building, stakeholder generation, prioritization, solution crowdsourcing, conference updates, tele-consultations, high-level advocacy, and more. #GlobalCardiacSurgery is bigger than what happens in the OR. #STS2020 ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (49/56) Importantly, #SoMe catalyzes inclusivity, pushing for #GenderEquity, youth involvement, & LMIC participation - key to advance #GlobalCardiacSurgery and ensure access to cardiac care for all. #STS2020

academic.oup.com/icvts/article/…
annalsthoracicsurgery.org/article/S0003-…
sciencedirect.com/science/articl… ImageImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (50/56) #GlobalHealth and cardiac surgery have become multi-billion dollar industries, yet #GlobalSurgery constitutes less than 1% of development aid for health, whereas cardiac industry still does not see a market in low- & middle-income countries. #GlobalCardiacSurgery #STS2020 ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (51/56) Changing that requires continuously challenging status quo w/ more evidence to make arguments. Trillions of $ in economic growth lost to CVD, of which billions (trillions?) due to lack of cardiac surgical care. CVD care not just prevention. #GlobalCardiacSurgery #STS2020 ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (52/56) Money makes the world go round: we need to start speaking the language. More cost-effectiveness analyses in LMICs, low-cost solutions (e.g., Del Nido cardioplegia), procedural/center costing data needed. Complexity & cost no longer excuse. #GlobalCardiacSurgery #STS2020 ImageImage
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (53/56) Public-private partnerships should be leveraged. Industry can reduce per-unit costs (shown by local industry in China & India), HIC centers can more consciously donate *functional* equipment, co-financing (eg, Narayana) can improve access. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (54/56) And recognition of reverse/trickle-up innovation & co-development not to be underestimated. US healthcare = expensive, whereas #UHC models continue to seek cost reductions to improve efficiency. Pressing #GlobalCardiacSurgery costs in LMIC = pressing costs in HIC.#STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (55/56) Children die from #CHD - not playing w/ friends. Adolescents are struck w/ failing heart valves due to #RHD - not attending school. Parents pass from #IHD - not caring for children. Numbers worse when recognizing these = people w/ families. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ (56/56) Think big, think broad. Leveraging collaborative efforts -twinning programs, PPPs, societal platforms, NGO coordination, and academic collaborations- and collectively speaking up will reach the tipping point. Fragmentation/silence will not. #GlobalCardiacSurgery #STS2020 Image
@STS_CTsurgery @GlobalCardiac @STS_Advocacy @roberthiggins32 @JessicaLuc1 @LuisDVelazcoDa1 @bzheleva @RwandaCardiac @VictorDayan1 @BavariaMd @TeamHeartRwanda @CHeartLink @EACTS_Journals @pomyers @EulertJ @rpribeiroMD @tamaranihici @vinck_e @GlobalARCH18 @emilebachamd @BadhwarVinay @MurilloBerlioz @MacCVSx @UMichCTSurgery @WCM_CTSurgery @AspiringCTS @ASuarezPierre @hibazghandour @sugychoi @S2Surgeon @worldheartfed @AHAScience @Surgeons4UHC @MLH_CHD @amyverstappen @DistyPearson @MariamAlboom @soreabg @Fostino21 @KrishDewan3 @AATSJournals @tssmn @Adelina_Mazhiqi @uma_parikh @MarlenaElodie @dukeHHproject @MayoClinic @BostonChildrens @IQICforCHD @AATSHQ Fruitful individual #GlobalCardiacSurgery discussions at #STS2020 - hoping for platform at #AATS2020 & #STS2021. Much data in pipeline to make stronger arguments, but much left to answer. Much interest growing & experience to leverage, but inclusive professional platform needed.
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Dominique Vervoort, MD
@DVervoort94
(1/9) I was unable to share my thoughts on #HLMUHC #UNGA on day of, but will do so with tweetorial below & my @nytimes commentary "Reversal in Health Coverage": nytimes.com/2019/09/24/opi…

I also want to thank everyone for warm words of support: my mother is doing better day by day.
(2/9) It’s been a landmark event as #HLMUHC moved mountains with political attention for #Health4All #UHC and the adoption of the Political Declaration. As per my op-ed for @ghn_news, reduced financial commitment but inclusion of #SurgeryUHC now apparent:

globalhealthnow.org/2019-09/cuttin…
(3/9) Major congratulations for the important #ChildHealth event by @Smiletrain et al.: “quality surgical care is a driver & outcome of development” #SurgeryUHC

1.7 BILLION CHILDREN live without access to surgery. #UNGA #UNGA74, what about that future? qz.com/1674518/theres…
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When I graduated from college, I really had no idea what I wanted to do. I was nominated for the Ruth Lily Fellowship, a national contest for poetry, and had I won, I was going to get an MFA. But I didn't win, and had no real plans otherwise. So I moved to New Orleans to write.
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Tara McCarty
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