Objectives: To evaluate the short term results of a single center program (Leipzig, Germany) for treating children since 2001 with cardiac diseases from developing countries. Treatment was offered without cost, was mediated through UK based charity Chain of Hope as part of a multifaceted approach to developing self sustaining local practice and included pediatric cardiology training (EG).
Methods: Retrospective chart review. Follow-up data gathered from referring institutions by email.
Results: 53 children referred for surgery (mean age 7.8 years). Predominant diagnoses were Tetralogy of Fallot (28%), VSD/AVSD (26%), ASD (13%) and complex lesions (9%), 17% had diagnostic modifications. 2 children, with complex lesions incorrectly diagnosed, were inoperable (fixed pulmonary hypertension, complex pulmonary atresia). 47 children underwent surgery, 4 transcatheter interventions and no early deaths. Follow-up data was available for 32 patients (62%; mean follow-up 2.2 years): functional status NYHA I in 29, II in 2 and 1 late sudden death 5 years after surgery (subaortic stenosis with LV dysfunction). The program did not adversely effect running the ‘routine’ pediatric cardiac program, financially or logistically.
Conclusions: Cardiac surgery can be offered to children from developing countries with excellent short term results. Patient selection is of utmost importance: lesions should be ‘curable’ without the foreseeable need for further interventions, but severe enough to have a major impact on morbidity and mortality if untreated. Close co-operation between local referring centers and international organizations is vital to ensure correct pre-referral diagnosis, safe transportation and long term outcomes of these often severely disabled children.