Abstract 188: Bridging the Gap: Development of Cardiac Surgery and Cardiac Diagnostic Interventional Registries in Resource Limited Settings in the West Indies
Authors: Henry Ronald , Rawlins Randolph , Dullum Mercedes , Rahaman Ganga Natasha , Elliott Victor , Griffith Kendall , Primus Elizabeth 
Published: March 2022

BACKGROUND
The value of establishing a regional West Indies Cardiac Surgery Registry for patients undergoing Open Heart Surgery was discussed in Trinidad in 2010. Collaboration among regional partners including Mr Roberto Casula of the Imperial College of London, other stake holders, database experts and the Doctors Inn Research group (DIRG) has sought to identify and manage key data entry fields for this Registry.

The need for a Caribbean PCI Registry was introduced and presented at the Caribbean Cardiac Society (CCS) meeting in 2011 in Trinidad. Over the last year, eight countries in the Caribbean with Cardiac Catheterization Laboratories and their associated invasive and interventional cardiologists have been identified for participation in the registry. The initial countries are Bahamas, Barbados, Belize, Guyana, Jamaica, Martinique, St. Croix and Trinidad. In November 2011 a decision was taken to include all thirteen (13) Cardiac Catheterization laboratories in the registry.

METHOD
A template comprising a list of variables for the West Indies Cardiac Surgery Registry and the Caribbean Cardiac Society Cardiac Diagnostic Interventional Registry was recommended by regional partners. These variables have been collated by the Doctors Inn Research Group on behalf of the CCS and include information on patient demographics, risk factors, cardiovascular history, operative details, complications, recommendations, and outcomes of cardiac intervention.

The goal of establishing the West Indies Cardiac Surgery and Caribbean Cardiac Society Cardiac Diagnostic Interventional Registries is to develop Caribbean wide registries to standardize cardiac practice, improve outcomes and accumulate regional data. In addition these initiatives seek to build a voluntary quality assurance tool relevant to the Caribbean environment having regard to its diversity and unique character and to provide a combined database of sufficient size to allow for meaningful research.

THE CHALLENGES
As a region with evolving technologies, in a resource limited environment the members of the Caribbean Cardiac Society deem it important to initiate voluntary aggregate reporting of consecutive cases/data for both Angiography and Cardiac Surgery. In this effort the following challenges to deployment were encountered and will be discussed:

· Ambitious overestimation of goals.
· Human resource limitations.
· Adverse work load to physicians’ ratios.
· Intra and inter-institutional rivalry and market place implications.
· Inter-institutional communication.
· Financial and funding limitations.
· Human resource sustainability.

SUMMARY
Status to Date: The registries have been approved by the stakeholders and are now online at www.wicsr.com and www.ccscdi.com. The members will begin populating the database in 2013 and we expect to have meaningful data to analyze by the end of the year.