IJCS | Volume 31, Nº4, July / August 2018

DOI: 10.5935/2359-4802.20180035 374 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2018;31(4)374-382 Mailing Address: Joel Silva Lima Passagem João Marcos, n: 9, Icuí-Guajará. Postal Code: 67125-099, Ananindeua, PA - Brazil. E-mail: joelsiilva@live.com Waiting for Cardiac Procedure in Congenital Heart Disease: Portrait of an a Hospital in the Amazonian Region Valeria Santos de Jesus, Aline Marques Nascimento, Rogério dos Anjos Miranda, Joel Silva Lima, Milene de Andrade Gouvea Tyll, Adriana de Oliveira Lameira Veríssimo Fundação Hospital de Clínicas Gaspar Vianna, Belém, PA - Brazil Manuscript received on February 5, 2017, revised on December 18, 2017, accepted on February 16, 2018. Abstract Background: Congenital heart disease is an important cause of morbidity and mortality in childhood, and in 50% of cases, surgery is required in the first year of life. A high deficit of surgical procedures is estimated in Northern Brazil. Objective: To analyze the waiting time for elective surgical treatment and/ or intervention in children with congenital heart disease in a Cardiology referral center, and to make considerations about heart diseases and forms of treatment in that institution. Methods: A cross-sectional study of all patients aged less than 14 years, with a diagnosis of congenital heart disease that were waiting for elective surgical or percutaneous cardiac treatment. Results: Among the 407 children with congenital heart defects, the most prevalent age group was > 2 to 6 years (34.0%). The average waiting time was 23.1 ± 18.3 months, with a median of 19. The most frequent heart disease was ventricular septal defect (28.98%), patent ductus arteriosus (18.42%) and atrial septal defect (11.05%). Most children (63.4%) were not from the metropolitan area. The percutaneous interventions represented only 27.84% of the catheterization procedures and 14,85% of all heart treatments. Approximately 60% of the pediatric surgeries occurred in children who were not previously registered due to urgency cases. Conclusion: Most of the children waiting for a cardiac procedure were not from the metropolitan area and had malformations potentially treatable by catheterization. It is necessary to increase the capacity of the single referral center in the state of Pará, as well as decentralize the high-complexity cardiological care in the metropolitan region. (Int J Cardiovasc Sci. 2018;31(4)374-382) Keywords: Heart Defects, Congenital / therapy; Waiting Lists; Heart Defects, Congenital / surgery; Epidemiology. Introduction Congenital heart defects, defined as structural abnormalities of the heart or the intrathoracic vessels, in different anatomical forms, are one of the most frequent congenital anomalies identified at birth. 1-3 These malformations are the ones with the greatest impact on children’s morbidity and mortality and on the cost of health services 4 and they represent the main cause of death among all congenital malformations. 5 The prevalence of congenital heart diseases is between four and nine per thousand live births, with an estimated 1.5 million new cases per year worldwide. 2,6,7 Hoffman estimated that between 1940 and 2002, 1.5 million people were born in the United States affected by heart disease. 2 In Brazil, 28,846 new cases of congenital heart disease are estimated per year. Spontaneous cure occurs in approximately 20% of the cases, related to less complex defects with a mild hemodynamic effect. 8