[Critical congenital heart diseases in Tuzla Canton area].

Critical congenital heart diseases (CHD) represent extensive and complex possibilities changes of morphology and homodynamic on the heart, which vital jeopardize child at the time of birth so as at the first weeks of its life or at the first months of its life too. The purpose of this study is to determine frequency, structure and the mode of medical treatment critical UAS in the Tuzla Canton area to harmonies with experiences and results we have reached in order to treat children who have congenital heart disease. There was discovered CHD in the 493 (8,15 per 1000 live-born) from 60.493 live-born children in Tuzla Canton area during the 10-year period start at 01.01.1995. Critical congenital heart disease was discovered in 142 children what represent total prevalence of 2,35 per 1000 live-born children. Yearly prevalence was pretty consistent in observed period of the time and it was from 1,36 to 3,24 per 1000 live born children. The most frequent UAS was complete atrio ventricular canal, which has proved in the 22,4% critical UAS. The more then one-third (36,6 %) children with critical UAS have had extra cardiac anomalies and syndromes. The balloon septostomy was performed in only two of our patients, in 41 (28,8 %) cardiac surgery was performed. Only one of the children underwent surgery in the neonatal period. In 8 patients who were no surgery treated developed pulmonary hypertension, one of them had bacterial endocarditic. Of the total 142 children with critical CHD 99 (69,7%) died. The 92 of them died before surgery, 7 of them died after the surgery; 3 of the 7 in the early after surgery period; 4 of the 7 died because of complications in a later period. Timely discovering critical UAS in Tuzla Canton area is failure in the area prenatal diagnosis. The treatment of patients is inappropriate and without possibilities of emergency invasive cardiac treatment and surgical treatment.