Early Outcomes of the First 500 Cardiac Surgeries at a Newly Established Rural Cardiac Centre in Pakistan: A Retrospective Observational Study

Abstract

Objectives: To evaluate early surgical outcomes, safety, and perioperative complications among the first 500 cardiac surgeries performed at a newly established rural cardiac center in Larkana. Methodology: This retrospective observational study included the first 500 consecutive cardiovascular surgeries performed at SICVD, Larkana, between December 2018 and August 2024. Patients undergoing coronary, valvular, and congenital cardiac surgeries were included. Operative risk was assessed using the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II). Early postoperative outcomes, including 7-day mortality and major complications, were analyzed using descriptive statistics. Results: The mean age of the cohort was 49.39 ± 13.05 years, with a male predominance of 72.6%. Smoking (48%), hypertension (34.6%), and diabetes mellitus (26.2%) were the most prevalent risk factors. Coronary artery bypass grafting constituted the majority of procedures (75.6%). The overall 7-day mortality rate was 1.8%, while isolated CABG was associated with a mortality rate of 1.5%. Postoperative complication rates remained low across procedure categories. Conclusion: The early experience from this rural cardiac center demonstrates that safe and effective cardiac surgical care can be delivered in underserved settings when supported by adequate infrastructure, funding, and a trained multidisciplinary team. These findings support the expansion of decentralized cardiac services to improve equitable access to care.