**8.1 Successes achieved**

After the ICHF/KHF mission in our center in 2003, pediatric cardiology and surgery activities in our center dwindled owing to dilapidated equipment, poor workers' remuneration, and brain drain as well as poor leadership, coupled with government directive

## *Establishing Sustainable Pediatric Cardiac Surgery Program in Nigeria: Challenges and Prospects DOI: http://dx.doi.org/10.5772/intechopen.102737*

to move UNTH to the permanent site without any building for pediatric cardiac surgery activities. In 2007, UNTH moved to the permanent site and then came a change in the leadership of NCTCE. Through continuous appropriate dialog and advocacy, NCTCE benefitted from TETFUND program. With advice from Prof. Tom Pezzella of ICHF, USA, a training center was found in India (ICHH, Hyderabad India), with institutional collaboration. With this development, pediatric cardiac anesthetists and intensivists, technicians, ICU and perioperative nurses including pediatric cardiologists got training within periods ranging from 6 months to 2 years.

There was the arrangement for pediatric cardiac surgeons to do 1 year training at the Indian center with the Indian team coming to our center to see a smooth takeoff of sustainable pediatric cardiac surgery program. However, that arrangement did not materialize because cardiac mission model was adopted. This cardiac mission model started in February 2013 and ended in October 2019. During the period, William Global Cardiac Alliance, Vincent Ohaju Memorial Foundation, Save-A-Heart-Nigeria, Cardiostart International, O'Pobic, Santarina all visited our center and performed operations in 113 in pediatric patients over 7 year period [23, 24].

Currently, our cardiologists can adequately handle all echocardiographic investigations. In addition, our adult cardiologists are able to handle all forms of cardiac pacemaker insertions, coronary angiography, and some coronary artery stenting and angioplasties. Our cardiothoracic surgeons with anesthesiologists and other theater staff can handle all non-open heart surgical procedures and some open-heart surgical procedures such as repair of atrial septal defects (ASD), repair of some ventricular septal defects (VSD), excision of some types of intracardiac tumors, and replacement of the mitral valve. We are still not able to do intracardiac repair for the blue babies in addition to some other types of congenital cardiac anomalies as well as some types of valve repair/replacement and coronary artery bypass procedures.

The COVID-19 pandemic has slowed the engagement of a resident foreign pediatric cardiac surgeon (GhanianModerl–ref) at NCTCE by the present UNTH/NCTCE management to equip the local surgeon with adequate skills that will make the program very sustainable.

*Congenital Heart Defects - Recent Advances*
