title: Congenital heart disease in Papua New Guinean children.
abstract: The aim of the study was to analyse critically the programme for surgical management of children in Papua New Guinea (PNG) with congenital heart disease. A hospital record-based analysis was undertaken to document the pattern, management and short-term outcome of surgery in PNG children referred with a diagnosis of congenital heart disease to the Royal Alexandra Hospital for Children in Sydney, Australia. On admission, physical examination, chest radiogram, electrocardiogram, cross-sectional echocardiogram and, in most cases, cardiac catheterization were performed. Of the 170 children referred over the 17-year period, 1978-1994, 165 were confirmed to have congenital heart disease and were included in the study. Their ages ranged from 2 months to 16 years (median 5.5) and the male to female ratio was 1:1. One-sixth had delayed milestones and one-fifth long-term wasting. A large number were tachypnoeic, in heart failure or had pulmonary hypertension on admission. Ventricular septal defect, 34%, tetralogy of Fallot, 23%, and patent ductus arteriosus, 16.4%, were the predominant defects. lesions such as aortic stenosis, coarctation of the aorta and transposition of the great arteries are under-represented. Altogether, 133 children (81%) had surgery; 75% were open- and 25% closed-heart operations. The complications were unremarkable and the mortality rate (6%) acceptable for the era. The programme was therefore very successful for a small proportion of children born in PNG with congenital heart disease.
authors.affiliation: Clinical Sciences Division, School of Medicine & Health Sciences, University of Papua New Guinea, PO Box 5623, Boroko, Papua New Guinea.
authors.forename: N
authors.initials: N
authors.lastname: Tefuarani
authors.forename: R
authors.initials: R
authors.lastname: Hawker
authors.forename: J
authors.initials: J
authors.lastname: Vince
authors.forename: A
authors.initials: A
authors.lastname: Sleigh
authors.forename: G
authors.initials: G
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D010219:Papua New Guinea; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography