African Annals of
Thoracic and Cardiovascular Surgery

OFFICIAL PUBLICATION OF THE AFRICAN ASSOCIATION OF THORACIC AND CARDIO-VASCULAR SURGEONS
  • Abbreviation: Afr. Ann. Thorac. Cardiovasc. Surg.
  • Language: English
  • ISSN: 1994-7461
  • DOI: 10.5897/AATCVS
  • Start Year: 2005
  • Published Articles: 34

The diagnosis and comprehensive management of congenital heart diseases in nations with severely restricted general and specialist healthcare services.

VINICIUS NINA MD., PHD 1,2, EMILY FARKAS MD, FACS 3,4, RACHEL H NINA MD., PHD 5,6, JANINE HENSON RN., BSN., CCRN7 , AUBYN MARATH., MBBS., MS., FRCSED., ATLS
1 Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil. 2 Member of the Board of Trustees for CardioStart International, Tampa, FL, USA. 3 Cardiothoracic Surgeon at the ThedaCare Heart Institute, Appleton, WI, USA. 4 Member of the Board of Trustees for CardioStart International, Emergency USA, Italy and VOOM Foundation, USA. 5 Universidade Ceuma, São Luís, MA, Brazil. 6 Volunteer for CardioStart International, Tampa, FL, USA. 7 Executive Vice-President of CardioStart International, Tampa, FL, USA 8 Founder and President of CardioStart International, Tampa, Fl, USA.

  •  Received: 09 January 2018
  •  Accepted: 18 January 2018
  •  Published: 30 June 2018

Abstract

Disease (CHD) in clinically sub-optimal settings. It is presented to provide simple diferences between certain conditions commonly seen in children with CHD for training doctors and nurses and other staff working within the speciality. In the majority of clinical presentations, a comprehensive, well structured training of a multidisciplinary team and carefully chosen hospital equipment and resources, can permit CHD to be safely and effectively treated by palliative or curative procedures. In our experience using this strategy, outcomes are almost comparable to those in advanced centers across the world. Among nations with severely restricted general and specialist healthcare resources, several issues must be overcome to diagnose and treat children with congenital heart diseases (CHD). The principal challenges to address are:

Provider issues

1. Lack of primary and tertiary specialist facilities to support, diagnose, treat, implement follow-up care and preventive measures within the community so that avoidable complications of these diseases can be identified and minimized.

2. Lack of trained personnel in most of the specialties needed to support pediatric cardiac services

Patient related issues

1. Maternal health issues affecting prematurity, dysmaturity, nutrition inadequacy during pregnancy threatening fetal development;

2. Child development issues: from insufficient nutritional support during post-natal growth; regionally limited, poor or absent primary healthcare; lack of preventative measures to reduce complications in such presentations ((for example, rheumatic fever, complicating CHD); With careful preparation using the algrorithms designed by CardioStart International, safely conducted complex operations can lead to good clinical outcomes throughout the peri-operative period. A vitally important component of these, is the “Dry Run Checklist” which allows the local team to confirm adequacy of equioment and disposables throughout the perioperative period. *[These are available on request]

Key-words: congenital heart diseases, surgery, healthcare deprived or restricted, review