A fuller editorial guide to cardiac surgery quality is coming soon. For now, the ranking below compares every country we have assessed on it — open a country's report for the cited detail behind its score.
Epidaurus · Treatment Guide · Therapeutic Interventions
Going abroad for —
Cardiac Surgery Quality
Cardiac/cardiovascular surgery quality including CABG, valve surgery, and interventional cardiology
The country comparison
Which countries are best for cardiac surgery quality
The destinations ranked high→low under this lens — each with the reasoning behind its score, the cited evidence one click down, and its full report. The verdict is free; the report is the depth.
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1
United Arab Emirates
AE
5.0/5
Good
The UAE demonstrates excellent cardiac surgery capabilities across all dimensions of the rubric. The country has 10-12 major cardiac surgery centers with comprehensive capabilities and 24/7 emergency services. Publish...
Full report
The evidence behind this score 7 cited points
- Cleveland Clinic Abu Dhabi ranked #1 cardiology in Middle East (Newsweek 2026), performed 839 cardiac procedures in 2024 with multiple international accreditations including ACC International Center of Excellence
- TAVR outcomes: 0.6% 30-day mortality and 99.5% device success, significantly better than U.S. Q1 hospitals (3.1% mortality)
- Sheikh Khalifa Medical City pediatric cardiac surgery mortality 2.68% (2015-2018), comparable to UK NICOR benchmark of 2.82%
- 10-12 hospitals with dedicated cardiac surgery programs featuring hybrid operating rooms, cardiac ICUs, and 24/7 emergency services across major centers
- Full spectrum of cardiac surgery subspecialties available including robotic CABG, valve repair/replacement, TAVI, pediatric congenital surgery, and aortic surgery
- Multiple international accreditations across major centers including JCI, ACC PCI lab accreditation, ACGME, and IAC Echocardiography certification
- Established medical tourism infrastructure with dedicated international patient programs, competitive pricing (CABG USD 33,000-95,000), and documented patient volumes
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2
Colombia
CO
5.0/5
Good
Colombia meets or exceeds Score 5 criteria across all dimensions. Hospital Internacional de Colombia (HIC) achieves 0.95% CABG mortality, independently validated through JCI Center of Excellence certification and well...
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The evidence behind this score 6 cited points
- HIC CABG mortality 0.95% among 316 patients (2022), JCI Center of Excellence validated, well below international 2% benchmark
- 6 JCI-accredited hospitals plus 12+ minimally invasive cardiac surgery centers providing comprehensive network coverage across 4 major cities
- High-volume cardiac surgery programs: HIC ~900 cases/year, Cardioinfantil ~1,212 cases/year, major centers perform 600-1,300 annual cases
- Comprehensive subspecialty offerings: CABG, minimally invasive valve repair/TAVI, robotic cardiac surgery, pediatric/congenital, ECMO (2 ELSO Gold centers), LVAD, heart transplantation
- Multiple international recognitions: HIC 6 consecutive JCI accreditations, Newsweek Five-Star designation, Mayo Clinic Care Network membership (2025), Cardioinfantil ranked 40th globally (Brand Finance 2025)
- Established medical tourism destination: ~85,000 international patients (2023), dedicated International Patient Offices, 70-85% cost savings vs. US, 3-7 hour flight from North America
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3
Germany
DE
5.0/5
Good
Germany operates one of the world's largest and most technically advanced cardiac surgery systems with 77 departments performing 103,617 classical heart surgery procedures annually. CABG mortality of 2.2% and valve su...
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The evidence behind this score 5 cited points
- 2024 DGTHG registry: 178,547 total procedures across 77 departments; 103,617 classical heart surgery procedures; CABG in-hospital mortality 2.2%; isolated valve surgery mortality 2.3–2.8%
- TAVI world leadership: >100,000 cumulative procedures by 2017; 81% of aortic valve interventions by 2020; in-hospital TAVI mortality declined from 10.4% (2008) to 2.5% (2020)
- Flagship institutions performing 2,500–2,850 cardiac surgeries annually with comprehensive capabilities including hybrid ORs, robotic surgery, dedicated pediatric cardiac surgery (550 operations/year at DHM Munich), and highest per-capita ECMO utilization globally (2,982 ECMO implantations in 2024)
- Mandatory legislative quality assurance through IQTIG with patient-level data and risk-adjusted models validated against full German population; DZHK networks 31 partner institutions recognized as top global contributor to European Heart Journal
- Established international patient destination with 250,000+ international patients treated annually, dedicated international offices at major cardiac centers with multilingual staff, and structured cardiac rehabilitation program (7,000 ambulatory heart groups with 125,000 participants)
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4
United Kingdom
GB
5.0/5
Good
The United Kingdom achieves world-leading cardiac surgery outcomes with CABG mortality at 1.0% and AVR mortality at 1.7%, both well below international benchmarks. The country operates 30+ major cardiac surgery center...
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The evidence behind this score 5 cited points
- CABG in-hospital mortality approximately 1.0% (2022–2023) and isolated aortic valve replacement mortality 1.7%, both at or below international benchmarks per NICOR NACSA 2025 Second Edition
- 30+ major NHS and private cardiac surgery facilities nationwide with 24/7 emergency cardiac catheterization and ECMO capabilities at multiple centers
- Royal Papworth Hospital performs approximately 2,400 major heart operations annually (highest UK volume); Cleveland Clinic London achieves 99.3% positive outcomes post open-heart surgery and 98% mitral valve repair success rate
- Full range of cardiac surgery subspecialties including pediatric congenital surgery (10,000+ patients/year), minimally invasive techniques (MIDCAB, endoscopic repair), TAVI, complex aortic surgery, and VAD support with world's highest myocardial recovery rate at Harefield
- NICOR NACSA recognized internationally as one of most comprehensive transparent national cardiac surgery outcome systems; all UK consultant cardiac surgeons hold GMC specialist registration after 7-year accredited training with mandatory revalidation
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5
Japan
JP
5.0/5
Good
Japan demonstrates exceptional cardiac surgery quality across all dimensions: 590+ accredited hospitals with 63,427 cardiovascular surgeries in 2023; CABG mortality 1.9% and valve surgery mortality 2.6% (at or below i...
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The evidence behind this score 5 cited points
- Hospital mortality: 1.9% for primary elective CABG and 2.6% for isolated valve replacement, at international benchmarks; Juntendo University maintains ~1% CABG mortality since 1984 with 0.7% stroke rate
- National infrastructure: 590+ JCVSD-registered hospitals performing 63,427 cardiovascular surgeries in 2023; NCVC (dedicated 550-bed cardiovascular center) performs >1,000 cardiotomy procedures annually with 24/7 cardiac catheterization lab and LVAD Center of Excellence designation
- World rankings: University of Tokyo Hospital ranked #1 in Asia-Pacific and #17 globally for cardiac surgery (Newsweek 2025); Sakakibara Heart Institute ranked #25 globally; 14 Japanese hospitals in top 50 Asia-Pacific
- Technical leadership: 58.7% off-pump CABG rate (among highest globally); MICS mitral valve repair in-hospital mortality 0.2%; 172 hospitals performing TAVI; congenital heart surgery program with <1% neonatal mortality; 7,000+ VA-ECMO cases annually
- Quality assurance: JCVSD audited since 2004 with 98.74% case registration accuracy; board certification linked to JCVSD participation; recognized as global best practice in BMJ Quality & Safety; active research in multiple registries (JCVSD, JRAD, JCCVSD, OCEAN)
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6
Malaysia
MY
5.0/5
Good
Malaysia demonstrates world-class cardiac surgery capabilities anchored by Institut Jantung Negara (IJN), which performed 4,563 cardiothoracic surgeries in 2024 with excellent outcomes: 97.8% survival for isolated CAB...
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The evidence behind this score 5 cited points
- IJN 2024 performance: 4,563 cardiothoracic surgeries with 97.8% isolated CABG survival rate (~2.2% mortality) exceeding EuroSCORE predictions
- 0% mitral valve repair mortality across 2022–2024; 0.4% VSD closure mortality; 3.1% pediatric congenital surgery 30-day mortality in 2024
- Infrastructure: 7 public + 48 private MHTC-member hospitals equipped for cardiac care; IJN operates 437 dedicated cardiac beds as Southeast Asia's largest independent cardiac center
- Specialization: Pediatric cardiac surgery (800–900 cases/year), ECMO program (20-year data), TAVI, Valve-in-Valve procedures, electrophysiology, hybrid operating theaters, Complex High-risk Indicated Patients (CHIP) coronary intervention program
- IJN ranked 40th in Asia Pacific for Cardiac Surgery (Newsweek 2025); SJMC ranked 44th; IJN holds world-first JCI Centre of Excellence for VSD and Malaysia-first JCI COE for Heart Failure
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7
Singapore
SG
5.0/5
Good
Singapore's cardiac surgery system demonstrates excellence across all key dimensions. Mortality rates (CABG 0.87%, valve surgery 1.88%, PCI 0.19% in 2024) substantially exceed international benchmarks and meet Score 5...
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The evidence behind this score 5 cited points
- NHCS 2024 outcomes: CABG 30-day mortality 0.87% (693 cases), valve surgery 1.88% (160 cases), elective PCI 0.19% (2,014 cases) — all well below international benchmarks
- NHCS performs 9,000 interventional and surgical procedures annually; NHCS conducts 2,000+ major cardiac procedures yearly across CABG, valve, and PCI, exceeding the 500+ threshold for high-volume programs
- Complete subspecialty coverage: pediatric congenital cardiac surgery at KKH (active since 1997), NUHCS aortic centre and minimally invasive programme (500+ MICTS patients by 2021), mechanical circulatory support including 75 ECMO procedures/year with ELSO Silver Award
- International recognition: NHCS first heart hospital outside USA/Asia for JCI accreditation (2005); NUHCS ranked #1 in Singapore for cardiac surgery (Newsweek 2022–2026); NHCS ranked #15 best cardiology hospital globally (Newsweek 2026); Singapore ranked 2nd in Medical Tourism Index with #1 rating for quality of facilities
- Procedural innovation: Asia's first TAVI (2009), Asia's first MitraClip (2011), Southeast Asia's first PASCAL valve repair (2025); established international patient programs with cost advantage (USD 15,000–40,000 vs. USD 70,000–200,000 in US) and 646,000 international patients in 2024
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8
Thailand
TH
5.0/5
Good
Thailand demonstrates excellent cardiac surgery quality with mortality rates at international benchmarks (CABG 1.62% in-hospital, valve surgery 2-4%), comprehensive infrastructure with 24/7 emergency capabilities acro...
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The evidence behind this score 8 cited points
- CABG in-hospital mortality rate of 1.62% (below <2% threshold for excellent quality)
- Valve surgery mortality rates of 2% for isolated mitral repair and 4% for replacement (at/below excellent benchmarks)
- 20,000+ annual cardiac surgeries with 90% success rate across multiple major centers
- 62 JCI-accredited medical facilities as of July 2024; Bumrungrad maintained JCI accreditation five times since 2002
- 24/7 cardiac catheterization lab and emergency capabilities at major centers (Bangkok Heart Hospital, Vejthani Hospital)
- Full range of cardiac surgery subspecialties including robotic-assisted surgery, hybrid operating rooms, ECMO support, TAVI, and minimally invasive techniques
- Bumrungrad's 99.2% PCI success rate exceeding US benchmark of 95%; 520,000+ international patients annually
- Established global medical tourism destination with 3.5+ million international patients annually and dedicated international patient support infrastructure
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9
United States
US
5.0/5
Good
The United States achieves excellent cardiac surgery quality with nearly 800 participating heart hospitals, CABG mortality of 2.5-2.7% (comparable to <2% threshold with many centers exceeding criteria), and 3,500+ car...
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The evidence behind this score 7 cited points
- Nearly 800 heart hospitals nationwide with 24/7 cardiac catheterization capabilities
- CABG mortality 2.5-2.7% nationally, with Cleveland Clinic achieving 1.5% for AVR procedures
- STS Database covers >97% of cardiac surgery with 1,000+ institutions and 3,500+ physicians
- Cleveland Clinic performs 5,600+ heart surgeries annually with highest quality ratings
- 40,000+ pediatric and congenital heart surgeries annually with outcomes 75% better than national averages at top centers
- Comprehensive subspecialty services including minimally invasive, robotic, ECMO, and mechanical circulatory support
- Cleveland Clinic ranked #1 in US for cardiology/heart surgery for 30 consecutive years by U.S. News & World Report
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10
India
IN
4.5/5
Good
India demonstrates excellent cardiac surgery infrastructure with 175+ dedicated centers, comprehensive subspecialties, extensive JCI/NABH accreditation, and a well-established international medical tourism reputation ...
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The evidence behind this score 8 cited points
- Overall cardiac surgery mortality 2.40%, at Score 4 threshold (2-3%) rather than Score 5 requirement (<2%)
- 175+ dedicated cardiac surgery centers performing 140,000+ annual open-heart procedures; 420 cardiac centers performing 300,000+ annual cardiac procedures
- Leading centers report 99.83% (Asian Heart Institute) and 99.6% (Apollo Heart Institute) bypass surgery success rates
- 45 JCI-accredited hospitals and 1,299 NABH-accredited hospitals meeting international quality standards
- Comprehensive subspecialties: TAVR, ECMO, minimally invasive techniques, robotic surgery, pediatric cardiac surgery available
- Established medical tourism destination with 2+ million international patients annually; one in 10 pediatric cardiac admissions are international patients
- Pediatric cardiac surgery mortality 5.63% vs Western standard 2.65%—more than double—indicating significant outcome disparity
- Documented system-wide challenges: geographic disparities (services clustered in southern states), workforce shortages, and quality variation across institutions
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11
Poland
PL
4.5/5
Good
Poland's cardiac surgery system demonstrates mature infrastructure and excellent outcomes that exceed most Score 4 benchmarks. The country operates 38 cardiac surgery centers performing ~27,000 annual procedures with ...
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The evidence behind this score 5 cited points
- 38 cardiac surgery centers with 116 dedicated operating rooms; 27,000+ annual cardiac procedures; 155 interventional cardiology centers with 98% operating 24/7
- CABG 30-day mortality 2.19% (men), 3.51% (women) across 133,973-patient KROK cohort (2009–2019); American Heart of Poland reports 1.4% overall mortality
- High-volume centers: John Paul II Hospital Kraków 1,603 open-heart surgeries/year; National Institute of Cardiology Warsaw 2,100+/year; Silesian Centre Zabrze 1,500+/year
- Full subspecialty range: CABG (13,000–14,000/yr), TAVI (4,904 in 2024), pediatric congenital (2,649/yr), LVAD at 5 designated centers, mechanical circulatory support programs
- Mandatory KROK registry since 2006 with 30+ peer-reviewed publications; ECRIN Scientific Partner status; Forbes 2021 Best Hospital award; but NO JCI accreditation and not yet established major medical tourism destination
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12
Spain
ES
4.5/5
Good
Spain operates one of Europe's most extensive cardiac surgery systems with 57–59 centers performing 21,133 major procedures annually, multiple internationally recognized hospitals (top-35 Newsweek ranking), and excell...
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The evidence behind this score 5 cited points
- Cardiac surgery volume: 21,133 major procedures across 57–59 centers in 2024 with 57-year-old national registry
- Quality outcomes: CABG mortality 2.4–2.8% (IMAR 0.80–0.93), aortic valve replacement 2.5% (IMAR 0.69), mitral repair 2.4% (IMAR 0.88); overall program IMAR 0.94 indicating consistent better-than-predicted outcomes
- Pediatric cardiac surgery: SJD Barcelona achieves 98.8% survival (250 procedures/year), validated as equivalent to Boston Children's Hospital by EACTS Registry
- International recognition: Two Spanish hospitals rank in Newsweek's global top-35 for cardiac surgery (Gregorio Marañón rank 28, La Paz rank 35); multiple JCI accreditations and ERN GUARD-Heart memberships
- Medical tourism: Growing destination with English-language programs at leading private hospitals, but not yet established as major international hub compared to Turkey or Thailand
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13
Turkey
TR
4.5/5
Good
Turkey demonstrates excellent cardiac surgery outcomes with CABG mortality of 1.96% and success rates of 98-99%, exceeding Score 5 quality benchmarks. Infrastructure includes 10+ major cardiac surgery centers with com...
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The evidence behind this score 5 cited points
- CABG mortality of 1.96% in 9,443-patient cohort, below the <2% threshold for excellence
- CABG success rates of 98-99% at leading centers, aligned with global benchmarks
- 50+ JCI-certified hospitals across major cities with comprehensive cardiac infrastructure
- Full cardiac surgery subspecialties including pediatric cardiac surgery, minimally invasive techniques, robotic-assisted procedures, and TAVI
- Established medical tourism destination with 1.8 million medical travelers to Turkey in 2023 and 700,000+ international patients annually
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14
Israel
IL
4.5/5
Good
Israel operates an advanced cardiac surgery system with 13 centers achieving 30-day operative mortality of 2.1–2.2% (2020–2022), competitive with international benchmarks and outperforming risk-adjusted predictions (O...
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The evidence behind this score 6 cited points
- 30-day operative mortality 2.1–2.2% from national registry covering 13 cardiac surgery centers (2020–2022); single-center study showed 1.95% mortality
- Risk-adjusted outcomes significantly outperform expectations (observed-to-expected ratio 0.63 vs STS predicted mortality)
- 13 cardiac surgery centers with mandatory national registry reporting; all major centers have 24/7 cardiac catheterization and are JCI-accredited
- Full surgical specialization: CABG (400–1,200/year at major centers), valve surgery, TAVI (1–2% mortality), LVAD (50/year), CARMAT artificial heart, pediatric cardiac surgery (400/year with minimally invasive techniques)
- International recognition: Sheba ranked 7th globally (Newsweek 2026), Hadassah top-6-consecutive-year cardiology leader, Israel 8th of 46 medical tourism destinations with 3rd-highest facility quality rating
- Established medical tourism destination with ~60,000 annual inbound medical tourists; cardiac bypass procedures cost $25,000–$40,000 (30–50% of US pricing) with comparable or superior outcomes
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15
Brazil
BR
4.0/5
Good
Brazil demonstrates good cardiac surgery quality with 337 cardiac centers, CABG mortality of 2.6% (BYPASS Registry), and valve surgery mortality of 4.4%, aligning with Score 4 thresholds. Infrastructure, workforce (10...
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The evidence behind this score 6 cited points
- BYPASS Registry: CABG in-hospital mortality 2.6%, valve surgery mortality 4.4%; 70,000–100,000 cardiac surgeries annually (second globally)
- Infrastructure: 337 national cardiac centers; InCor performs ~3,100 procedures/year with 14 operating rooms and 170 ICU beds
- Workforce: ~900 certified cardiac surgeons at 10.4 per million population, exceeding high-income country averages; 228 residency positions annually
- International recognition: InCor ranked #28 globally for cardiac surgery (Newsweek 2026), Albert Einstein #42; Brazil leads Latin America with 25 JCI-accredited hospitals
- Subspecialties: Full range available including robotic cardiac surgery, TAVI (3,194 cases 2008–2023), LVAD programs, ECMO, and pediatric congenital surgery at 46 centers
- Medical tourism: Established destination with cost advantage of 40–70% below US prices; dedicated international patient services at HCor and Albert Einstein
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16
South Korea
KR
4.0/5
Good
South Korea demonstrates good cardiac surgery quality with strong infrastructure (11 centers operating 24/7), excellent performance in valve surgery (2.5-3.7% mortality, meeting Score 5 standards) and TAVI procedures ...
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The evidence behind this score 8 cited points
- Valve surgery mortality 2.5-3.7% annually from 4,000+ cases, meeting Score 5 excellence standard
- 11 cardio-cerebrovascular disease centers operating 24 hours across country with 13,909 total annual cardiac operations
- TAVI procedures at 20 institutions with 3.3% cardiac deaths at 1 year and 98% success rate at Asan Medical Center
- 95% of emergency patients receive coronary angiography within 90 minutes of ER arrival
- 29 JCI-certified hospitals; Asan Medical Center ranked world's top institution in interventional cardiology by Cardiovascular Research Foundation
- 2.76 million foreign patients attracted 2009-2019 with established international centers and dedicated medical tourism infrastructure
- CABG mortality 6.6% 90-day and 9.5% 1-year, exceeding Score 4 threshold; high-volume centers show 75% lower mortality than lowest-volume hospitals
- 96.2% short-term cardiac surgery survival rate and 84% 4-year survival rate; 28 congenital heart surgeons performing 3,000 congenital operations annually
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17
Hungary
HU
3.5/5
Moderate
Hungary operates five university cardiac surgery centers with recent major infrastructure investments and comprehensive subspecialty coverage, but open-heart surgery mortality at its highest-volume center (Debrecen: 3...
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The evidence behind this score 6 cited points
- Debrecen open-heart surgery mortality 3.8–4.7%, within Score 3 range but below Score 4 threshold of 2–3%
- Five university cardiac surgery centers with 3,000–4,000+ annual cardiac procedures nationally
- Comprehensive subspecialties: pediatric cardiac surgery (Gottsegen), aortic arch surgery (Városmajor), TAVI (1,000+ at Debrecen, 250+ planned for 2026), ECMO, LVAD since 2011
- Recent major infrastructure: HUF 9.1 billion Városmajor expansion (2025), hybrid ORs at multiple centers, state-of-the-art imaging and transplant ICU
- International recognition: ERN GUARD-Heart membership (Szeged), ECHSA Congenital Database registration, national registries, but no JCI accreditation for major cardiac centers
- Medical tourism: Cost advantage (40–70% vs. Western Europe) but not yet structured destination; 1,738 dedicated rehabilitation beds nationally
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18
Jordan
JO
3.5/5
Moderate
Jordan demonstrates strong cardiac surgery infrastructure (7-8 centers, high-volume programs >2,000 cases/year at QAHI), comprehensive subspecialty coverage, and established international reputation with 224,000 medic...
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The evidence behind this score 6 cited points
- QAHI performing >2,000 open-heart cases annually; Jordan Hospital performing ~2,000 catheterization/intervention cases per year, indicating high-volume centers that typically achieve superior outcomes
- Published CABG 30-day mortality of 5.9% (1,046 patients) and valve surgery operative mortality of 5.8% (346 patients) from single-center retrospective studies, above Score 4 benchmarks but within Score 3 range
- One Jordanian center (Princess Muna Cardiac Center) achieving 1.12% CABG stroke rate—below international 3% benchmark—demonstrating potential for excellent outcomes at select centers
- Specialty Hospital as first in Jordan and seventh globally with JCI disease-specific Cardiac Center of Excellence accreditation for AMI and Heart Failure (2018, maintained multiple cycles)
- Comprehensive cardiac surgery subspecialties including pediatric/congenital, valve repair/replacement, TAVI, minimally invasive techniques, and complex endovascular work available across multiple centers
- Strong medical tourism ecosystem: 224,000 medical tourists in 2024 (up from 202,592 in 2023), cardiac surgery among top procedures sought, established international patient departments with translation services
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19
Mexico
MX
3.0/5
Moderate
Mexico has established cardiac surgery infrastructure with 5-10+ major centers and internationally trained surgeons offering advanced techniques including pediatric cardiac surgery and minimally invasive procedures. H...
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The evidence behind this score 6 cited points
- Instituto Nacional de Cardiología Ignacio Chávez reported 9.2% overall cardiac surgery mortality in 2015 with 8% in-hospital intensive care deaths, exceeding international benchmarks of 2-3% for CABG and 3-5% for valve surgery
- Infrastructure includes multiple major centers: Angeles Hospital (28 hospitals, 234 surgical suites), ABC Medical Center (ranked first in Mexico for cardiology/heart surgery), Hospital Zambrano Hellion (ranked #3 in México), with advanced capabilities including ECMO, hemodynamic rooms, and robotic-assisted surgery
- Cardiac surgeons are internationally trained in prestigious US, Canada, and European institutions with extensive experience in renowned centers; cardiologist training requires over 10 years of rigorous study
- Specialized programs include pediatric congenital cardiac surgery (Centro Médico ABC and Kardias since 2012) and minimally invasive techniques (TAVI, robotic-assisted CABG, Percutaneous Coronary Intervention)
- JCI accreditation limited to only 7 private hospitals in Mexico, with JCI having no legal standing in the country; ABC Medical Center has 13 years continuous JCI accreditation
- Established medical tourism destination for North American patients with cost savings of 50-70% compared to US procedures, though outcome transparency and follow-up care coordination for international patients remain undocumented