Critical congenital heart disease detection in the ANDES: Challenges and opportunities.

Critical congenital heart disease (CCHD) represents a challenging problem in global health equity due to the need for specialized surgical or transcatheter intervention within the first year of life. CCHD screening using pulse oximetry (POS) has led to significant improvements in mortality due to early referral and intervention. Andean America represents one of the few regions in the world with increasing CHD deaths and variable POS implementation. In this manuscript, we review the current state of CCHD in Andean America, the challenges and opportunities for developing new POS algorithms that account for high-altitude physiology, data on regional cost-effectiveness supporting POS implementation and outline future directions to achieve equity in CHD care in this region.