Congenital heart disease in Papua New Guinean children

The aim of the study was to analyse critically the programme for surgical m anagement of children in Papua New Guinea (PNG) with congenital heart disea se. A hospital record-based analysis was undertaken to document the pattern , management and short-term outcome of surgery in PNG children referred wit h a diagnosis of congenital heart disease to the Royal Alexandra Hospital f or 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 mont hs 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 wer e tachypnoeic, in heart failure or had pulmonary hypertension on admission. Ventricular septal defect, 34%, tetralogy of Fallot, 23%, and patent ductu s arteriosus, 16.4%, were the predominant defects. Lesions such as aortic s tenosis, coarctation of the aorta and transposition of the great arteries a re 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 there fore very successful for a small proportion of children born in PNG with co ngenital heart disease.