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Congenital cardiac defects continue to be a major cause of death and suffering in the low/middle-income countries.1 This stems from the larger burden of congenital heart defects in these countries,2 coupled with the paucity of specialised centres and the reported worse outcome of operations in the existing centres. These facts have stimulated concerted efforts to establish new sustainable centres3 and, importantly, developing strategies to improve outcome in the existing centres.
The Heart paper by Khan and colleagues4 is a welcome addition to the literature as it highlights the advantages, as well …
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.