Pediatric Cardiac Surgery Unit, Cardiovascular Division, Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.
Pediatric Cardiovascular Surgery Department, Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV), São Paulo, São Paulo, Brazil.
Braz J Cardiovasc Surg. 2022 Aug 16;37(4):566-574. doi: 10.21470/1678-9741-2022-0141.
In some developing countries, congenital heart disease still stands out among the leading causes of death in the first year of life. Therefore, there is a great need to develop programs designed to improve outcomes in the diagnosis and surgical treatment of congenital heart disease in these nations, where children have always been and still are severely underserved. The Brazilian Public Health Care System demands universal access to treatment as a constitutional right. Therefore, an underfunded Pediatric Cardiac Surgery program is unacceptable since it will cost lives and increase the infant mortality rate. Additionally, poor funding decreases providers' interest, impedes technological advances and multidisciplinary engagement, and reduces access to comprehensive care. Unfortunately, in most developing countries, Pediatric Cardiac Surgery progress is still the result of isolated personal efforts, dedication, and individual resilience. This article aims to present the current state of Brazilian pediatric cardiac surgery and discuss the structural and human limitations in developing a quality care system for children with congenital heart disease. Considering such constraints, quality improvement programs via International collaboration with centers of excellence, based on proper data collection and outcomes analysis, have been introduced in the country. Such initiatives should bring a new dawn to Brazilian Pediatric Cardiac Surgery.
在一些发展中国家，先天性心脏病仍然是导致婴儿第一年死亡的主要原因之一。因此，非常有必要为这些国家制定旨在改善先天性心脏病诊断和手术治疗结果的计划，在这些国家，儿童一直且仍然得不到充分的服务。巴西公共医疗保健系统将获得治疗作为一项宪法权利。因此，一个资金不足的儿科心脏外科计划是不可接受的，因为这将导致生命损失和婴儿死亡率上升。此外，资金不足会降低提供者的兴趣，阻碍技术进步和多学科参与，并减少获得全面护理的机会。不幸的是，在大多数发展中国家，儿科心脏外科的进展仍然是孤立的个人努力、奉献和个人韧性的结果。本文旨在介绍巴西儿科心脏外科的现状，并讨论在发展先天性心脏病儿童优质护理系统方面存在的结构和人力资源限制。考虑到这些限制，通过与卓越中心的国际合作，引入了质量改进计划，基于适当的数据收集和结果分析，这些计划已在该国开展。这些举措应为巴西儿科心脏外科带来新的曙光。
