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Review
. 2025 Apr 15;14(8):e040003.
doi: 10.1161/JAHA.124.040003. Epub 2025 Apr 7.

Pediatric and Congenital Cardiac Services: An Innovative and Empowering Approach to Global Training and Equitable Care

Wyman W Lai  1   2 , Dominique Vervoort  3   4 , David Bradley  5 , Antonio G Cabrera  6 , Casey Culbertson  7 , Alejandro Floh  8 , Saurabh K Gupta  9 , Babar S Hasan  10 , Adrian Holloway  11 , Jeffrey P Jacobs  12 , Kathy J Jenkins  13   14 , R K Kumar  15 , L A Larrazabal  16 , Colin J McMahon  17   18   19 , Daniel J Penny  20   21 , Alistair Phillips  22 , Emilio Quezada  23 , Craig A Sable  24 , Shubhika Srivastava  25 , Sandra L Staveski  26 , Patcharapong Suntharos  27 , David F Teitel  23 , Betsy Tirado  28 , Brian C Tran  7 , Bistra Zheleva  29 , Liesl Zuhkle  30   31 , Anthony C Chang  1   32
Affiliations
Review

Pediatric and Congenital Cardiac Services: An Innovative and Empowering Approach to Global Training and Equitable Care

Wyman W Lai et al. J Am Heart Assoc. .

Abstract

Congenital heart disease is a leading cause of preventable death in children, with a disproportionate impact on low- and middle-income countries. Despite progress in treating congenital heart disease globally, significant challenges remain in accessing specialized cardiovascular care, particularly cardiac surgery, in low- and middle-income countries. This review examines current models of assistance and proposes a novel global training program to address these inequities. Key challenges identified include building program infrastructure, training health care providers, ensuring financial sustainability, and promoting local engagement. The proposed program, structured under a new international organization, will leverage emerging technologies to deliver accessible and rigorously assessed training in pediatric and congenital cardiac care. By collaborating with local experts and global partners, the program will promote access to education for various health care personnel involved in congenital heart disease care, establish credentialing standards, and foster global collaboration. This unified, scalable approach aims to bridge the health equity gap and accelerate progress toward comprehensive and sustainable cardiac care programs worldwide.

Keywords: cardiac surgery; congenital heart disease (CHD); global health training; health equity; low‐ and middle‐income countries (LMIC).

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Conflict of interest statement

Dr Lai reports service as Board of Director for National Board of Echocardiography; service on the Board of Directors for CHAMPS Children Foundation; service as Medical Director for MD1World; service as Board of Directors for sSCAPE; and employment by CHOC Children's. Dr Vervoort reports service as Medical Advisory Council member for Global Alliance for Rheumatic and Congenital Hearts. Dr Cabrera reports employment by Nationwide Children's Hospital. Dr Floh reports compensation from Office of the Chief Coroner, Ontario for consultant services. Dr Jacobs reports compensation from American Academy of Dermatology for consultant services and compensation from SpecialtyCare for consultant services. Dr Zuhlke reports employment by South African Medical Research Council. The remaining authors have no disclosures to report.

Figures

Figure 1
Figure 1. Pediatric cardiac surgeons per million population (registered with CTSNet in August 2017, n=3858).
Map created at www.mapchart.net. CTSNet indicates Cardiothoracic Surgery Network. Reprinted from Vervoort et al.8 with permission. Copyright ©2020, Elsevier.
Figure 2
Figure 2. A standardized global approach to pediatric cardiology training with an emphasis on engagement and empowerment.
NGO indicates nongovernmental organization.
Figure 3
Figure 3. Role of an international organization in improving graduate medical education and credentialing.
AI indicates artificial intelligence; Gov. governmental agency; Grad., graduate; Hosp, hospital; Int'l, international; MedEd, medical education; NGO, nongovernmental organization; Org., organization; PC, pediatric cardiology; PCCC, Pediatric and Congenital Cardiac Services; Prof., professional; Soc., society; and Uni, university.
See this image and copyright information in PMC

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