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