Piero Abbruzzese, MD

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First Joint Scandinavian Conference in
Cardiothoracic Surgery August 20-22, 2009,
Stockholm, Sweden
EMERGENCY
High standard , free of charge cardiac surgery in
Africa 2 years experience
Piero Abbruzzese, MD Director, Division of
Cardiac Surgery Director, Department of
Surgery Ospedale Infantile Regina Margherita,
Torino, Italy EMERGENCY, Italy
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About EMERGENCY
Non political, neutral and independent
humanitarian organization
established
in 1994 in Milan, Italy
Over 3,177,000 patients
treated in 15 countries
Approximate budget 25,000,000 Euros per year,
with administrative costs of 6
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Mission
To provide high standard and free of charge
medical and surgical assistance to victims of
landmines, war and poverty To promote a culture
of peace, solidarity and respect for human rights

EMERGENCY
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Battambang, Cambodia
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Erbil, Iraq
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Kabul, Afghanistan
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Anabah, Afghanistan
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Moving forward...
from responding to
war-related urgent
needs...
...to sharing human rights
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We hereby declare the Right
to be Cured as a basic and
unalienable right belonging to each and every
member of the human community
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Building Human Rights through Medicine
Building Medicine through Excellence
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The Salam Centre for Cardiac Surgery
Construction started in 2004 Opening on May 3,
2007
EMERGENCY
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Pannelli solari
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Soluzioni
tecniche innovative
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The Salam Centre for Cardiac Surgery
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Centro di meditazione
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Tre sale operatorie
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The Salam Centre for Cardiac Surgery
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The Salam Centre for Cardiac Surgery
3 Operating Rooms 15 ICU
beds 16 sub-ICU beds 32 Ward beds
Outpatients clinics Laboratory and Blood Bank
Echocardiography Radiology
Catheterization Laboratory CT scan
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The Salam Centre for Cardiac Surgery
Clinical Activities
April 2007-June 2009
Outpatients Consultations 16105
Cardiological Examinations 9389
Hospital Admissions 2306
Patients operated 1431

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The Salam Centre for Cardiac Surgery
(April 2007- June 2009)
1431 patients operated
from 15 Countries
3,14 operative mortality
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The Salam Centre for Cardiac Surgery
Surgical Activity
1431 patients operated
(April 2007-June 2009)
254 17.7
CHD
88 6.1
IHD
14 1
Other
Age 13 days to 65 years (mean age
26.7 15)
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The Salam Centre for Cardiac Surgery
Surgery for VHD
1075 patients
Multiple Valves Surgery 480 (44,6 )
Mitral Valve Surgery 478 (44,5)
Aortic Valve Surgery 115 (10,7)
Tricuspid Valve Surgery 2 (0,2)

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The Salam Centre for Cardiac Surgery
ASD 56 Fallots Tetralogy
57 VSD
42 PDA
35 A-V Septal Defects 17
TAPVC 7
Supravalvar AS 2
Subvalvar AS 17
Pulmonary Stenosis 6
TGA 2
Tricuspid Atresia
1 Interrupted Aortic Arch
1 Sinus of Valsalva fistula
1 Ebsteins anomaly
1 Subvalvular Pulmonary stenosis
2 Aortic coarctation
2 Double Outlet Right Ventricle
2 Isolated Mitral valve cleft
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Surgery for CHD
254 patients (6 months activity) Age 13 days. to
50 yrs (mean 12.7 9.4 yrs)
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The Salam Centre for Cardiac Surgery
88 patients Age 55 6.7 years
Surgery for IHD
Average N of CABG per patient 2.5
Female 28 Male 60
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The Salam Centre for Cardiac Surgery
Catheterization Laboratory
(15 months activity)
Diagnostic Procedures 459
PTCA 65
Procedures for CHD 67
Pacemaker implants 6
Pericardiocentesis 2
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Catheterization Laboratory
Procedures for CHD
67
Pulmonary Valvuloplasty 37 Aortic
Valvuloplasty 1 Tricuspid Valvuloplasty
1 PDA closure 18 ASD closure 3 VSD
closure 2 Coarctation dilatation
2 Rashkind septostomy 3
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The Salam Centre for Cardiac Surgery
Surgical Mortality
30-days Mortality Rate
1431 patients
3.14
45 Deaths
LO Syndrome 20 Pulmonary Hypertension
3 Ischemic stroke 3 MOF 9 Haemorragic
shock 4 Technical failure 2 Ventricular
Arrhytmia 2 Myocardial
Infarction 1 Massive Thrombo
embolism 1
Causes of Death
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Patients 1431 Complications
141(9,8 )
Morbidity
30 days complications
Low Cardiac Output 29
Ventricular Arrhytmias 24
A-V Block 4
Valve Disfunction 9
Valve Trombosis 1
Operated Valve Endocarditis 4
Acute Renal Failure 23
Acute Respiratory Failure 9
Acute Liver Failure 3
Cerebrovascular accident 21
Seizures 9
Mediastinitis 1
Wound Infection 1

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6-months Follow-up
Pts. operated between April 2007 and March
2008Number of patients 383 (85,9 of the total)
Alive 375 (97,9) Dead 8
(2,1)
1 year Follow-up
Pts. operated between April 2007 and Sept.
2007 Number of patients 151 (76,3 of the total)
Alive 145 (96) Dead 6 (4)
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Our vision and key principles
The Manifesto
for a Human Rights
based Medicine
Signatory Countries (Aug 09) Central African
Republic Chad
Democratic
Republic of Congo Egypt
Eritrea
Rwanda

Sierra Leone
Sudan
Uganda
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We hereby declare the Right
to be Cured as a basic and
unalienable right belonging to each and every
member of the human community
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...We therefore advocate the implementation of
health systems and projects solely devoted to
preserve, extend and improve the life of the
people in need and based on the following
principles
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Equality
Every human being has the right to be cured
regardless his economic and social condition,
gender, race, language, religion and opinions.
Standards of health care, set by the progress of
medical knowledge, must be delivered equally and
without discrimination to all patients.
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Quality
In order to strengthen and generate human,
scientific and material resources, quality
systems must be based on communitys needs, up to
date with the achievements of medical science,
and not oriented, shaped or determined by lobbies
and corporations involved in the health industry.

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Social responsibility
Governments should have the health and well
being of their citizens as their priority, and
allocate adequate human and financial
resources. The services provided by health
systems and humanitarian projects in the health
sector must be accessible to and free of charge
for all.
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We commit to plan and develop EQS based
policies health systems and projects.
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An EQS-based Medicine is
respectful of human rights
effective in providing health care
appropriate to develop medical science
crucial in building Health Systems
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Thank you