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Challenges of Congenital Heart Surgery in Brazil: It is Time to Designate Pediatric Congenital Heart Surgery
Valdester Cavalcante Pinto1,2, Leonardo Augusto Miana3, Fábio Binhara Navarro4,5
1Department of Pediatric Cardiovascular Surgery, Instituto de Coração de Fortaleza, Fortaleza, Ceará, Brazil.
Insights
Congenital heart disease (CHD) impacts many newborns, requiring specialized surgical care. Establishing Pediatric Cardiovascular Surgery as a subspecialty can improve outcomes and align Brazil with international standards.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease (CHD)
Background:
- Congenital heart disease (CHD) affects 8-10 per 1,000 births, with Brazil reporting 23,057 new cases in 2022.
- Approximately 25% of children with CHD need surgery in their first year; 81% are expected to survive to 35.
- Challenges include surgical complexity, lack of subspecialty recognition, and difficulties in accessing specialized treatment for families.
Purpose of the Study:
- To highlight the critical need for Pediatric Cardiovascular Surgery to be recognized as a distinct subspecialty.
- To explore the benefits of specialization in improving patient care, research, and education for congenital heart disease.
- To advocate for adopting international best practices in Brazil's approach to CHD treatment.
Main Methods:
- Review of current challenges in pediatric cardiovascular surgery and congenital heart disease care.
- Comparative analysis of subspecialty recognition in countries like the USA and UK.
- Discussion of essential components for achieving excellence in CHD care.
Main Results:
- Specialization in Pediatric Cardiovascular Surgery is crucial for addressing the complexities of CHD.
- International models demonstrate that subspecialty autonomy drives advancements in research, education, and patient outcomes.
- Brazil can enhance its CHD care by establishing this subspecialty.
Conclusions:
- Recognizing Pediatric Cardiovascular Surgery as a subspecialty is vital for advancing CHD care in Brazil.
- Adopting international standards through specialization will improve treatment efficacy and patient survival rates.
- Specialization fosters a more mature and capable healthcare system for children with congenital and acquired heart conditions.
Abstract:
Congenital heart disease (CHD) affects eight to ten out of every 1,000 births, resulting in approximately 23,057 new cases in Brazil in 2022. About one in four children with CHD requires surgery or other procedures in the first year of life, and it is expected that approximately 81% of these children with CHD will survive until at least 35 years of age. Professionals choosing to specialize in CHD surgery face numerous challenges, not only related to mastering surgical techniques and the complexity of the diseases but also to the lack of recognition by medical societies as a separate subspecialty. Furthermore, families face difficulties when access to services capable of providing treatment for these children. To address these challenges, it is essential to have specialized hospitals, qualified professionals, updated technologies, sustainable industry, appropriate financing, quality assessment systems, and knowledge generation. The path to excellence involves specialization across all involved parties. As we reflect on the importance of Pediatric Cardiovascular Surgery and Congenital Heart Diseases establishing themselves as a subspecialty of Cardiovascular Surgery, it is essential to look beyond our borders to countries like the United States of America and United Kingdom, where this evolution is already a reality. This autonomy has led to significant advancements in research, education, and patient care outcomes, establishing a care model. By following this path in Brazil, we not only align our practice with the highest international standards but also demonstrate our maturity and the ability to meet the specific needs of patients with CHD and those with acquired childhood heart disease.
