Cardiac surgery has undergone a remarkable transformation over the past few decades, evolving from highly invasive, high-risk procedures to precision-driven, patient-centred interventions. Today, the “state of the art” in cardiac surgery reflects a convergence of advanced technology, refined surgical techniques, multidisciplinary collaboration, and data-driven decision-making.

Cardiac surgery in Bangladesh has evolved from a limited, highly specialized service into an established and expanding discipline that now serves a large and growing population with cardiovascular disease. This progress reflects decades of institutional development, professional commitment, and gradual technological advancement within a resource-constrained healthcare system.

From the early 2000s onward, cardiac surgery services expanded beyond the National Institute of Cardiovascular Diseases into private sector institutions, public medical colleges, and military hospitals. Several centers in Dhaka and other major cities began offering routine open-heart surgery, significantly increasing national surgical capacity. The establishment of postgraduate training programs, including MS and FCPS in Cardiothoracic and Vascular Surgery (CTVS), strengthened workforce development and contributed to a steady rise in the number of trained cardiac surgeons.

Over the past two decades, cardiac surgery in Bangladesh has steadily aligned with global standards through significant technological and clinical advancements. Many centers have adopted off-pump coronary artery bypass (OPCAB) surgery, reducing complications associated with cardiopulmonary bypass and improving outcomes in high-risk patients. Refinements in myocardial protection strategies and cardiopulmonary bypass techniques have enhanced intraoperative safety and postoperative recovery. Surgical expertise has expanded beyond routine procedures to include valve replacement surgery, as well as aortic and congenital heart surgery in selected specialized centers.

Minimally invasive cardiac surgery (MICS) represents one of the most important contemporary developments in this field. In Bangladesh, Prof. Sazzad introduced minimally invasive cardiac surgery in 2015, pioneering the adoption of less invasive surgical techniques aimed at reducing surgical trauma, shortening hospital stays, and improving patient recovery. His work contributed significantly to advancing modern cardiac surgical practices within the country.

In 2025, Prof. Sazzad further strengthened this vision by establishing the Unico Heart Surgery Center at Unico Hospitals PLC, where he is the founder of the Cardiothoracic and Vascular Surgery (CTVS) department. The center was designed as a modern, smarter cardiac care facility dedicated to advanced heart surgery, integrating contemporary surgical technology, structured perioperative care, and multidisciplinary collaboration to deliver high-quality cardiac treatment.

Today, Bangladesh performs thousands of cardiac surgical procedures annually, catering to both adult and pediatric cardiac diseases. Despite this substantial progress, the healthcare system continues to face significant challenges, including a high patient load disproportionate to available surgical capacity, late presentation of cardiac disease, and limitations in resources and trained manpower, particularly outside major urban centers.

Therefore, it is essential to refocus our efforts to maintain a high standard of surgical outcomes while simultaneously introducing state-of-the-art practices. Aligning surgical techniques, infrastructure, and clinical protocols with those of the developed world ensures that patients receive the safest and most effective care. Such an approach not only minimizes postoperative complications and mortality but also fosters innovation, attracts skilled professionals, and strengthens confidence in the healthcare system. In essence, continuous improvement and adoption of advanced practices are crucial for delivering world-class cardiac care while sustaining excellence in surgical outcomes.