Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-29T12:05:59.441Z Has data issue: false hasContentIssue false

Management of patients with congenitally malformed hearts in Indonesia

Published online by Cambridge University Press:  22 October 2007

Anna Ulfah Rahajoe*
Affiliation:
Department of Cardiology and Vascular Medicine, Medical Faculty University of Indonesia, National Cardiovascular Centre, Jakarta, Indonesia
*
Correspondence to: Anna Ulfah Rahajoe, Department of Cardiology and Vascular Medicine, Medical Faculty University of Indonesia, National Cardiovascular Centre – “Harapan Kita” Jl. Letjend. S Parman. Kav. 87, Jakarta 11420, Indonesia. Tel: 62 21 568 4083; Fax: 62 21 568 4130; E-mail: [email protected]

Abstract

At a crude rate in Indonesia of 20 births per 1000 population, the total number of annual live-births is approximately 4.5 million. Considering the estimate of 9 of each 1000 affected live-births, 40,500 infants with congenitally malformed hearts are added every year to the total pool. The number of surgical procedures for such congenital cardiac malformations in the whole country in 2005 was 706. The majority of cases are undetected, contributing to a high rate of infant mortality. In the period of 3 years from 2003 through 2005, 1366 patients underwent open and closed cardiac surgical procedures at the National Cardiovascular Center in Jakarta. The rate of death was 5.56%, with a complexity score as calculated for the Aristotle system of 6.25, which is at the medium level. The proportion of surgical procedures performed in infancy has increased, but the rate of mortality for complex surgery in this particular group is still high. Non-surgical interventions have increased every year, but the cost is higher than for surgery, except for balloon pulmonary valvoplasty. Thus, by any reckoning, paediatric cardiac care in Indonesia is still in its infancy. The barriers are: lack of awareness of congenitally malformed hearts, limited resources and facilities, the high cost of treatment, and limited financial support. Training programmes exclusively dedicated to paediatric cardiology and paediatric cardiac surgery need to be established in centers with good standards of paediatric cardiac care.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Hoffman, JL, Kaplan, S. The incidence of congenitally malformed hearts. J Am Coll Cardiol 2002; 39: 18901900.CrossRefGoogle Scholar
2. Wren, C, O’Sullivan, JJ. Survival with congenitally malformed hearts and need for follow up in adult life. Heart 2001; 85: 438443.CrossRefGoogle ScholarPubMed
3. Subramanyan, R, Joy, J, Venugopalan, P, Sapru, A, al Khusaiby, SM. Incidence and spectrum of congenitally malformed hearts in Oman. Ann Trop Paediatr 2000; 20: 337341.CrossRefGoogle ScholarPubMed
4. Samanek, M, Voriskova, M. Congenitally malformed hearts among 815,569 children born between 1980 and 1990 and their 15-year survival: a prospective Bohemia survival study. Pediatr Cardiol 1999; 20: 411417.Google Scholar
5. Roy, DL, McIntyre, L, Human, DG, et al. . Trends in the prevalence of congenitally malformed hearts: comprehensive observations over a 24-year period in a defined region of Canada. Can J Cardiol 1994; 10: 821826.Google Scholar
6. Robida, A, Folger, GM, Hajar, HA. Incidence of congenitally malformed hearts in Qatari children. Int J Cardiol 1997; 60: 1922.CrossRefGoogle ScholarPubMed
7. Fixler, DE, Pastor, P, Chamberlin, M, Sigman, E, Eifler, CW. Trends in congenitally malformed hearts in Dallas County births. 1971–1984. Circulation 1990; 81: 137142.CrossRefGoogle ScholarPubMed
8. Bitar, FF, Baltaji, N, Dbaibo, G, Abed el-Jawad, M, Yunis, KA, Obeid, M. Congenitally malformed hearts at a tertiary care center in Lebanon. Middle East J Anesthesiol 1999; 15: 159164.Google Scholar
9. Harimurti GM, Roebiono PS, Rilantono LI, Suhardiman, Wahab S. Congenitally malformed hearts in newborn infants in several hospitals in Indonesia. Presented in: Asian Congress of Cardiology 1997, Jakarta-Indonesia.Google Scholar
10. Pýnar, H. Postmortem findings in term neonates. Semin Neonatol 2004; 9: 289302.CrossRefGoogle Scholar
11. Daenen, W, Lacour-Gayet, F, Aberg, T, et al. . Optimal structure of a congenital heart surgery department in Europe by EACTS Congenitally malformed hearts Committee. Eur J Cardiothorac Surg 2003; 24: 343351.Google Scholar
12. Hall, R, More, R, Camm, J, et al. . Fifth Report on the provision of services for patients with heart disease. (United Kingdom) Heart 2002; 88 (III Suppl): iii1iii59.Google Scholar
13. Leung, MP, Yung, TC, Ng, YK, et al. . Pattern of symptomatic congenitally malformed hearts among oriental neonates – a decade’s experience. Cardiol Young 1996; 6: 291297.Google Scholar