Abstract
Background: Cardiovascular care remains limited in sub-Saharan Africa. Since its establishment in 2015, the Benjamin Mkapa Hospital (BMH) in Dodoma, Tanzania, has gradually strengthened its cardiology and cardiothoracic services through the integration of high-tech diagnostics, interventional procedures, and surgical capabilities, aiming to meet the growing demand for advanced medical care in Tanzania.
Objective: To describe the evolution of cardiology and cardiothoracic services at the BMH, assess performance and challenges, and report on procedures conducted between 2019 to 2024.
Methodology: A retrospective descriptive analysis was conducted on patient document review and the hospital electronic database between February 2019 and August 2024. The study included both pediatric and adult patients who received care in the cardiology and cardiothoracic department.
Results: The transformation of cardiovascular services at the BMH from 2018 resulted in providing advanced cardiovascular care to patients in central Tanzania. A total of 1,313 procedures were performed, including 1,215 adult cardiac catheterization procedures (1,081 diagnostic coronary angiographies, 115 percutaneous coronary interventions, and 19 pacemaker implantations), 55 pediatric cardiac catheterization procedures (16 right heart catheterizations, 10 atrial septal defect device closures, 18 patent ductus arteriosus device closures, and 11 pulmonary valve valvuloplasty), and 43 open-heart surgeries, consisting of 36 congenital heart disease repairs, two valve replacements, and five coronary artery bypass grafts. Among 115 patients who underwent percutaneous coronary intervention, four died, yielding a success rate of 96.5%. Of the 43 patients who underwent open-heart surgery, three deaths were recorded, resulting in a success rate of 93.0%. These deaths were mainly due to advanced disease and surgical complications.
Conclusion: The experience underscores the importance of strategic investment, leadership, and partnerships in advancing health system resilience and equity in low-resource settings. A total of 1,313 patients benefited from minimally invasive procedures and open-heart surgeries in the five years of the cardiology and cardiothoracic department’s establishment.