PRACTICING PAEDIATRIC CARDIOLOGY IN RESOURCE LIMITED COUNTRY LIKE PAKISTAN

Abstract

Objective: This study was carried out to document different modifications ofstandard procedures in order to reduce the cost without compromising thequality of the procedure.

Methodology: The department of Paediatric Cardiology at AFIC/NIHD Pakistan isproviding medical and surgical treatment to children with congenital and acquiredheart disease since 1985. Since the introduction of paediatric cardiologyservices, it has evolved into advanced interventions. All patients requiringdiagnostic and therapeutic cardiac catheterizations from Jan 2011 to Dec 2016were enrolled in the study. A number of local modifications were done duringcardiac catheterization and all the modifications were recorded.

Result: During these 6 years, the interventions done in catheterization suit at ourinstitution were 45.8% (2730/5957). It included 1106 duct occlusions, 271pulmonary valve dilations, 699 atrial septal defect closures, 96 VSD Deviceclosure, 42 mitral valve dilations, and 74 others. Most of the diagnostic as well astherapeutic cardiac catheterizations were done under local anesthesia 43%(2562) with deep sedation and saving general anesthesia fee.

Conclusion: Modifications of different standard procedures for cardiaccatheterization in expert hands may overcome financial hurdles without affectingthe outcome.

Key Word: Cardiac catheterization; Atrial septal defects; Ventricular septaldefects; Patent ductus arteriosus.