Surgical management of complex congenital heart diseases in the context of South-South cooperation: case series

Complex congenital heart diseases, such as common arterial trunk (CAT) and aortopulmonary window (APW) with interrupted aortic arch (IAA), present challenges in low-resource settings where technical limitations restrict surgical care. We describe three cases referred from Cameroon and treated at the Jakaya Kikwete Cardiac Institute (JKCI) in Tanzania through authentic South-South cooperation with the purpose of describing clinical, anatomical, and surgical aspects of these patients, and assessing this collaborative model. The patients, aged 7 months to 3 years, included two CATs and one APW with an interrupted aortic arch, all complicated by severe pulmonary hypertension. Multidisciplinary management allowed for surgical repair in two of the cases, but one child died intraoperatively despite intensive intervention, while the third was deemed inoperable and remained on medical management. These cases are illustrative of the viability and benefits of South-South cooperation, of the role of multidisciplinary care and building capacity locally for improved outcomes.