The improvement of care for paediatric and congenital cardiac disease across the World: a challenge for the World Society for Pediatric and Congenital Heart Surgery

Abstract

The diagnosis and treatment for paediatric and congenital cardiac disease has undergone remarkable progress over the last 60 years. Unfortunately, this progress has been largely limited to the developed world. Yet every year approximately 90% of the more than 1,000,000 children who are born with congenital cardiac disease across the world receive either suboptimal care or are totally denied care.While in the developed world the focus has changed from an effort to decrease post-operative mortality to now improving quality of life and decreasing morbidity, which is the focus of this Supplement, the rest of the world still needs to develop basic access to congenital cardiac care. The World Society for Pediatric and Congenital Heart Surgery [http://www.wspchs.org/] was established in 2006. The Vision of the World Society is that every child born anywhere in the world with a congenital heart defect should have access to appropriate medical and surgical care. The Mission of the World Society is to promote the highest quality comprehensive care to all patients with pediatric and/or congenital heart disease, from the fetus to the adult, regardless of the patient's economic means, with emphasis on excellence in education, research and community service.We present in this article an overview of the epidemiology of congenital cardiac disease, the current and future challenges to improve care in the developed and developing world, the impact of the globalization of cardiac surgery, and the role that the World Society should play. The World Society for Pediatric and Congenital Heart Surgery is in a unique position to influence and truly improve the global care of children and adults with congenital cardiac disease throughout the world [http://www.wspchs.org/].

Quality of life in children with congenital heart disease after cardiac surgery

“…Both palliative and corrective surgery aims to improve QoL. 4,5 Our study showed that post-operative children aged 13-18 years had poorer physical function than healthy children, while social, emotional, and school function showed no significant differences in this age group. It was probable that this difference was caused by residual shunt, late diagnosis and late surgery in 13-18 years old group (mean post operative duration was 19 months prior to study).…”

“…Both palliative and corrective surgery aims to improve QoL. [4][5][6][7] Several studies have shown that the QoL of children with CHD after surgical correction was poorer in comparison with healthy children. 3,8,9 A study in Poland assessed QoL in subjects 10 years after corrective cardiac surgery.…”

Reducing Mortality and Infections After Congenital Heart Surgery in the Developing World

“…2 Approximately 90% of births worldwide occur in developing countries that have limited resources and high expected morbidity and mortality due to congenital heart disease. 3,4 The establishment of surgical programs allows an increasing number of children access to life-saving surgery. Congenital heart surgery carries considerable risk for death, even in programs in the developed world.…”

Risk Prediction and Outcome Analysis

“…The STS Congenital Heart Surgery Database has worked collaboratively at the international level on a joint European Association for Cardiothoracic Surgery (EACTS)-STS Congenital Database Committee, particularly on standardization of definitions and naming conventions [22,23,24]. Moreover, the World Society for Pediatric and Congenital Heart Surgery has gathered surgeons from over 50 countries and from all continents except Antarctica to work on pediatric cardiology and pediatric cardiac surgery [25,26,27].…”