Pediatric Cardiac Service Development in Croatia.

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Public Health

Background:

• Approximately 330 children born annually in Croatia have congenital heart disease (CHD).
• Lack of organized pediatric cardiac services in Croatia prior to independence.
• Initial reliance on international humanitarian missions (NGOs) for pediatric cardiac surgery.

Approach:

• Development of a pediatric cardiac service program in a limited-resource country.
• Collaboration with a US-based NGO for surgical missions (1993-2003).
• Gradual development of local surgical and interventional cardiology expertise.

Key Points:

• 601 children operated on during the NGO program (1993-2003).
• Post-program, 60% of patients were referred abroad; only 40% of surgeries performed domestically.
• Improved local expertise, including a specialized congenital heart surgeon, led to increased capacity and reduced foreign referrals.
• Current capacity allows for most standard congenital heart surgeries and interventional procedures domestically.

Conclusions:

• Croatia has achieved significant progress in establishing a high-quality pediatric congenital heart disease center.
• Ongoing challenges and areas for improvement in comprehensive CHD care remain.
• The program now independently operates on 180 patients annually with low mortality.