IJCS | Volume 31, Nº4, July / August 2018

377 Figure 1 - Distribution of patients waiting for elective pediatric cardiac procedures according to the place of residence in mesoregions. Lower Amazon Southwest of Pará Belém Metropolitan Area Northeast of Pará Southeast of Pará Marajó Jesus et al. The wait for surgical treatment of heart disease Int J Cardiovasc Sci. 2018;31(4)374-382 Original Article this estimate, in addition to new births with congenital heart disease, the reintervention cases. In 2002, a total of 8,092 patients underwent surgery, which shows a 65% gap – with higher rates in the Northern Region (93.5%). 9 In the present study, it was observed that of the 407 children diagnosed with congenital heart disease, the most prevalent age groups were preschoolers (> 2 to 6 years) and schoolchildren (> 6 to 12 years), with no neonates waiting for treatment. These results differ from those observed in the analysis of the prevalence of congenital heart diseases at the time of the first consultation in a pediatric hospital in the city of Curitiba, state of Paraná, where there was a predominance of children with congenital heart disease in the infancy period, followed by the neonatal period, with 52.1%, and 19.4%, respectively. 11 Considering that the sample of the present study refers to the patients waiting for elective procedures, this may reflect the differences regarding the time of referral for these patients and the delay during the waiting period. Regarding the type of congenital heart disease, the most frequent one was VSD, followed by PDA and ASD. These results are consistent with those found in the study by Aragão et al., 12 who demonstrated the following frequencies: VSD (21%), PDA (18%), Tetralogy of Fallot (14%) and ASD (7.7%). As for Huber et al., 13 they were as follows: VSD with or without associations (13.9%), Tetralogy of Fallot (12.9%), obstructive lesions of the right ventricular outflow tract (9.8%), and isolated ASD (9.6%). It can be said that the assessed institution had similar characteristics to those observed in other regions of Brazil. The most frequent origin of the children who comprised the waiting list for cardiologic procedures was the Belém Metropolitan Mesoregion, a result consistent with those of a referral hospital in the Northeast region of Brazil, where most of the children came from the metropolitan region of the state. 12 However, 63.4% of the children did not live in the MetropolitanRegion of Belém; thus, a point to be discussed is the need to qualify newhigh cardiovascular complexity referral units in the State of Pará. For the geographical distribution of the High Complexity Care Services in Pediatric Cardiovascular Surgery, according toOrdinance 210, 14 which is based on the proportion of 1:800 thousand inhabitants, the State of Pará needs nine centers capable of performing pediatric cardiovascular surgery, but the regionalization of services has not yet occurred, generating