IJCS | Volume 31, Nº4, July / August 2018

380 Figure 2 - Type of hemodynamic procedure performed. Diagnostic cardiac catheterization 73.91% Diagnostic cardiac catheterization + percutaneous intervention 21.2% Percutaneous intervention 4.89% Jesus et al. The wait for surgical treatment of heart disease Int J Cardiovasc Sci. 2018;31(4)374-382 Original Article Table 5 - Hemodynamic procedures performed according to the type of intervention per year Procedure 2012 2013 2014 Diagnostic cardiac catheterization 77 87 108 Diagnostic cardiac catheterization + percutaneous intervention 24 27 27 Cardiac catheterization + angioplasty 23 17 13 Cardiac catheterization + embolization 0 3 0 Cardiac catheterization + PDA/ ASD/ VSD closure 0 3 5 Cardiac catheterization + atrial septostomy 0 1 0 Cardiac catheterization + valvuloplasty 1 3 9 Percutaneous intervention 14 4 0 Pulmonary Embolization 1 1 0 Valvuloplasty 5 1 0 Angioplasty 8 1 0 PDA closure 0 1 0 PDA: patent ductus arteriosus; ASD: atrial septal defect; VSD: ventricular septal defect. Table 6 - Cardiac surgery and therapeutic hemodynamic procedures Treatment 2012 2013 2014 Surgical 201 (84.10) 207 (86.97) 158 (85.40) Percutaneous 38 (15.89) 31 (13.02) 27 (14.59) interventions remained stable, with only one record of case that was not treated due to structural limitations, considering the limited number of beds in the institution. 18 Making investments aiming to reducing the waiting time for congenital cardiovascular procedures also improves morbimortality outcomes. However, this generates high short-term costs to the Brazilian Unified Health System (SUS). The devices used for closure of ASD, VSD and PDA are not covered by SUS, which creates more difficulties in their acquisition. There is also the challenge of financial transfer, sometimes insufficient for cardiac surgeries, limiting their increase. The fact that there is almost no differentiation regarding the payment of the procedure related to its degree of complexity punishes the referral center dedicated to the more complex cases and discourages the increase in the number of procedures in neonates and infants, especially in the higher complexity cases. Some international studies