Establishing a Sustainable Adult Cardiac Surgery Program in Rwanda

Rwanda, a country in Sub-Saharan Africa, has experienced a growing burden of cardiovascular diseases (CVDs), reflecting the global epidemiological transition from communicable to non-communicable diseases. In response to this increase, the Government of Rwanda has implemented various strategies, including the integration of CVD services into primary healthcare facilities and the strengthening access to specialized clinical care. Cardiac surgical services led by visiting international teams were initiated in 2006 at King Faisal Hospital Rwanda (KFHR). Over the past 17 years, these visiting teams have performed more than 300 cardiac surgeries. Subsequently, an in-house open-heart surgery program for pediatric patients was established, followed by the initiation of an adult cardiac surgery training program in 2024. To date, more than 250 adult patients have undergone complex cardiac surgical procedures, including ascending aortic aneurysm repair, aortic valve repair or replacement, mitral and tricuspid valve surgery, coronary artery bypass grafting, total arterial revascularization, pericardiectomy, and complex lung resections. Clinical outcomes from these procedures are comparable to those reported in similar settings with long-established cardiac surgery programs. The establishment of a sustainable adult cardiac surgery program in Rwanda represents a major milestone in reducing the financial burden associated with sending patients abroad for specialized care. In addition, the program has embedded a structured local academic training pathway and fostered research and innovation. Despite these achievements, key challenges remain, including shortage of essential supplies, an insufficient number of trained technical personnel and specialists, limited epidemiological data, and the absence of comprehensive costing models. To address these challenges, Rwanda is actively mobilizing and allocating human and financial resources while strengthening stakeholder collaboration to ensure the sustainability of the adult cardiac surgery program.