International journal of cardiology. Congenital heart disease
May 15, 2026 · via Europe PMC
Surgical management of adults with congenital heart disease in Serbia: A pilot model.
Giamberti A, Caldaroni F, Guglielmi G, Veljkovic S, Perunicic A, Brida M, Chessa M, Nikolic A.
AI summary — for doctors, generated from the abstract only
A ten-year international partnership between an Italian and Serbian cardiac center enabled surgical treatment of 244 adults with congenital heart disease in Serbia, achieving in-hospital mortality (4.5%) and long-term outcomes comparable to high-volume Western European centers despite limited local case volume and expertise.
What was studied
Retrospective single-center study at the Institute for Cardiovascular Disease Dedinje (ICDD) in Belgrade, Serbia, describing outcomes of a structured collaboration with an Italian cardiac surgery center (visiting surgeon support) for adult congenital heart disease (ACHD) surgery in consecutive adult patients (over age 18) operated on between January 2014 and December 2024.
Key findings
- 244 adult CHD patients underwent surgery at ICDD over the 10-year period, with 88 (36%) requiring complex procedures referred to the visiting surgeon.
- Mean age at surgery was 34.8 years (±14 years); right ventricular outflow tract pathology accounted for 89% of cases, and 80% of patients (70 patients) underwent reoperation after a prior procedure.
- In-hospital mortality was 4.5% (4 of 244 patients).
- No additional deaths or reoperations occurred during a mean follow-up of 58 months (range 2-122 months).
Clinical relevance
These findings suggest that an international partnership model combining local surgical access with visiting specialist support may enable high-quality ACHD surgical care in countries with limited case volume and expertise, potentially informing similar collaborative models elsewhere, though this reflects outcomes from a single partnership rather than a broadly generalizable system.
Who should care
Limitations
This is a retrospective, single-center case series without a comparison group or randomization; outcomes may not generalize to other low-volume centers or partnerships, and selection of patients referred for complex procedures could influence the reported mortality and complication rates.
A decade-long Italy-Serbia surgical partnership delivered ACHD surgery outcomes comparable to high-volume Western centers, suggesting this collaborative model could work elsewhere.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
In 2014 a professional collaboration was established between IRCCS Policlinico San Donato, Milan, Italy (PSD) and the Institute for Cardiovascular Disease Dedinje, Belgrade, Serbia (ICDD) to support and improve the care of adult patients with congenital heart disease (ACHD) in the country. Since 2018, this collaboration has become more structured, with a specific focus on surgery for adults with complex congenital heart disease (CHD). Aim of the study was to evaluate the outcomes of this collaboration.
Methods
We conducted a retrospective study on all consecutive adult patients (aged over 18 years) with CHD who underwent surgery at the Institute for Cardiovascular Disease Dedinje (ICDD) over a ten-year period, from January 2014 to December 2024. Collected data included number of cases, mean age at surgery, types of surgical procedures performed, number of previous operations, distribution of cases based on complexity, patient outcomes, and follow-up.
Results
Between 2014 and 2024, a total of 244 ACHD patients underwent surgery at ICDD. Eighty-eight of these patients (88/244 = 36%) required complex procedures and were referred to the visiting PSD cardiac surgeon. Mean age at surgery was 34.8 years (±14 years). The most common diagnosis was right ventricular outflow tract (RVOT) pathology, accounting for 89% of cases. Seventy patients (80%) underwent reoperations following previous procedures. In-hospital mortality was 4.5% (4 patients). No additional deaths or reoperations occurred during a mean follow-up of 58 months (2-122 months).
Conclusions
This ten-year international partnership demonstrates that high-quality ACHD surgical care can be delivered sustainably in countries with limited case volumes and expertise. By combining local access with external specialist support, the model has achieved outcomes comparable to high-volume Western European centres. Increased access to ACHD surgery in their home country and reduced financial burden suggests that this model of care may potentially serve in other countries facing similar healthcare challenges.
DOI
10.1016/j.ijcchd.2026.100682
PMID
42199919
PMCID
PMC13200079
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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