Evaluation of Congenital Heart Defects Treatment Options-Establishment of Pediatric Cardiology/Cardiosurgery in Bosnia and Herzegovina

Abstract

Introduction:Modern pediatric cardiology mainly deals with congenital heart defects (CHD), as the most common congenital anomalies. In most cases CHD requires surgical or interventional treatment.Goal:The goal of the research was to evaluate CHD treatment at Pediatric Clinic, University Clinical Center (UCC) Sarajevo, Bosnia and Herzegovina (B&H). UCC Sarajevo is the only institution in B&H where cardiac treatment of CHD in pediatric population is performed. Pediatric cardiosurgery has started to develop in Bosnia and Herzegovina in April 1997.Patients and methods:Study included 745 patients (period from April 1997 to January 2017).Results:Cardiac treatment was performed on 745 patients with CHD, 541 (72.6%) of them were acyanotic patients and 204 (27.4%) were cyanotic patients. Reoperation was performed in 49 (6.5%) of patients. Out of total number of patients, 59 (7.9%) died. In 660 children (88.5%) a complete correction and in 85 (11.5%) a palliative operation/correction was performed. Defects with left to right shunt were present in 397 (53.2%) patients, complex heart defects with Tetralogy of Fallot in 173 (23.2%), obstructive heart defects in 106 (14.2%), obstructive heart defects with shunt in 53 (7.1%), and others in 16 (2.1%) of patients. During surgery, extracorporeal circulation was regulated in 554 (74.3%) patients. Peri and early postoperative complications occurred in 180 (24.1%) of patients. During this period 24 pacemakers were implanted and 24 radiofrequency ablations were performed.Conclusion:Results of CHD cardiac treatment in childhood, which took place simultaneously, followed by the contractual joint programs and individual work of the Bosnian and Herzegovinian team has reached the highest level in the last two years, not only by the number, type and complexity of corrected CHD, but also by the age and body weight of the patients who underwent surgery, and development of invasive procedures, arrhytmology, pacemaker placement, intensive peri and postoperative treatment. That led pediatric cardiac surgery of UCC Sarajevo, to a position of leading center in the region.

Management and Invasive Cardiological Review by Comparison of Percutaneous Coronary Intervention in Left Anterior Descending Artery with Drug Eluting and Bare Metal Stents

“…Support to the development of systemic approach to programs for preventing and monitoring the leading risk factors for the most frequent illnesses at the level of FBiH, in particular cardiovascular diseases, through the improvement of records, documentation and evaluation, as well as the availability of preventive health services at the level of Primary Health Care /Family Medicine teams ( 6 , 7 , 8 , 9 , 10 ).…”

“…Cardiovascular diseases are the leading cause of morbidity and mortality in the world, with 29% of total annual mortality. It is estimated that by 2030, 23.6 million people will die annually of heart disease, or every two seconds in the world will cause a death due to cardiovascular disease ( 8 - 10 ). Cardiovascular diseases are the cause of death in our country, especially in younger age population, according to data from the FBiH Public Health Institute.…”

Treatment Approach for an Infant with Complex Congenitally Corrected Transposition of the Great Arteries

“…Modern pediatric cardiology mostly deals with congenital heart defects (CHD) which comprise one quarter of all congenital anomalies (1)(2)(3). CHDs are divided into anomalies with a left-right shunt or right-left shunt, obstructive anomalies and complex anomalies (1)(2)(3). Complex anomalies account for 20% of all CHDs and they are very difficult to diagnose, demanding in terms of follow-up, and risky for surgical treatment (palliation, radical surgeries, hybrid surgeries and anatomical and physiological correction) (4).…”