The cost of open heart surgery in Nigeria

Introduction: Open Heart Surgery (OHS) is not commonly practiced in Nigeria and most patients who require OHS are referred abroad. There has recently been a resurgence of interest in establishing OHS services in Nigeria but the cost is unknown. The aim of this study was to determine the direct cost of OHS procedures in Nigeria. Methods: The study was performed prospectively from November to December 2011. Three concurrent operations were selected as being representative of the scope of surgery offered at our institution. These procedures were Atrial Septal Defect (ASD) Repair, Off Pump Coronary Artery Bypass Grafting (OPCAB) and Mitral Valve Replacement (MVR). Cost categories contributing to direct costs of OHS (Investigations, Drugs, Perfusion, Theatre, Intensive Care, Honorarium and Hospital Stay) were tracked to determine the total direct cost for the 3 selected OHS procedures. Results: ASD repair cost $ 6,230 (Drugs $ 600, Intensive Care $ 410, Investigations $ 955, Perfusion $ 1080, Theatre $ 1360, Honorarium $ 925, Hospital Stay $ 900). OPCAB cost $ 8,430 (Drugs $ 740, Intensive Care $ 625, Investigations $ 3,020, Perfusion $ 915, Theatre $ 1305, Honorarium $ 925, Hospital Stay $ 900). MVR with a bioprosthetic valve cost $ 11,200 (Drugs $ 1200, Intensive Care $ 500, Investigations $ 3040, Perfusion $ 1100, Theatre $ 3,535, Honorarium $ 925, Hospital Stay $ 900). Conclusion: The direct cost of OHS in Nigeria currently ranges between $ 6,230 and $ 11,200. These costs compare favorably with the cost of OHS abroad and can serve as a financial incentive to patients, sponsors and stakeholders to have OHS procedures done in Nigeria.