Abstract
BACKGROUND: Congenital heart defects (CHDs) constitute the predominant pediatric congenital anomaly in Yemen, substantially contributing to childhood morbidity and mortality. AIM: This study aimed to investigate the outcomes of pediatric cardiac surgery, specifically comparing results between foreign and local surgical teams. METHOD: A retrospective cohort study was conducted using data from January 2004 to December 2019, sourced from a local electronic database and manual registration system. Demographic information, in-hospital complications, mortality, and length of stay were analyzed. The Aristotle Basic Complexity Score (ABC score) was used to categorize surgical procedures. RESULTS: The cohort of 2052 patients experienced an overall complication rate of 36.2% and a mortality rate of 6.4%. Extended hospital stays (> 7 days) were associated with a higher complication rate (p < .001). Less complex procedures demonstrated lower complication and mortality rates. Surgical complexity and prolonged hospital stays were identified as predictors of postoperative complications and mortality. While the local team was a predictor of postoperative complications. Notably, mortality did not significantly differ between foreign and local teams (p = .194). CONCLUSION: Local teams successfully increased surgery volume while achieving comparable mortality rates to foreign teams. However, higher complication rates and extended hospital stays persist for cases managed by local teams, underscoring the need for targeted training and resource optimization.