title: [Preventing complications of cardiac malformations in poor countries].
abstract: Natural selection and therapeutic efficiency limit the type of cardiac malformations that/can be treated in poor countries. Most of the patients studied here are those with left-to-right shunts (arterial, atrial and, especially, ventricular), right-to-left shunts associated with a ventricular septal defect (tetralogy of Fallot) or an atrial septal defect (trilogy of Fallot), and stenosis of the pulmonary or aortic valves. Early diagnosis is crucial, but this will require a new health policy involving specially trained nurses or technicians equipped with cheap portable echo-Doppler machines to examine babies' hearts. We then analyze the follow-up and medical treatment of these common cardiac disorders and the need for "national" centers for open- and closed-heart surgery and catheterization. We feel we have achieved our training goal when a center is able to close a VSD in a 6-month-old baby with a low rate of morbidity and mortality.
authors.affiliation: Centre de référence des malformations cardiaques congénitales complexes - M3C, Hôpital Necker-Enfants malades - 149, Paris. daniel.sidi@nck.aphp.fr
authors.forename: Daniel
authors.initials: D
authors.lastname: Sidi
mesh_terms: D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D003906:Developing Countries; D042241:Early Diagnosis; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007223:Infant