Aim: To analyze the experience of treatment of congenital heart disease. Identify the proportions and ratios of surgical and endovascular treatments. Development of diagnostic service. To determine the impact of industry funding mechanisms on the development of endovascular surgery for congenital heart disease.
Materials and methods: The tendencies of cardiac surgery development of congenital heart defects on the basis of the analysis of endovascular and surgical methods of treatment are considered. Own results of 10 years of experience in the treatment of congenital heart disease are presented.
Results: An increase in the proportion of endovascular methods and a decrease in surgical treatments. The obtained data show a rapid increase in the share of medical procedures (from 48.9% to 89.4%) and a sharp decline in the share of diagnostic procedures (from 51.1% to 10.6%) in endovascular surgery. Early mortality after cardiac surgery in children is <5%, mortality after edovascular interventions - <1%. Ultrasound examination (ultrasound) of the heart - allows to detect 95% of all congenital heart defects and is shown to every citizen as a screening method. The influence of industry financing mechanisms on the development of endovascular surgery of congenital heart defects is shown. Expensive equipment began to be purchased at public expense, the number of equipment representatives on the market increased and, as a result, the number of endovascular procedures increased. Over the past 5 years, public funding for the needs of the industry has increased from 16 to 75%.
Conclusions: Today, pediatric cardiology and cardiac surgery are reaping the fruits of the golden age in medical science. With the development of cardiac surgery, the number of operated patients increases every year. The successful outcome of treatment of patients with CHD depends on a comprehensive multidisciplinary team (Heart Team). New evidence-based approaches in resuscitation management allow to recover as soon as possible after the intervention. We see further development of the industry in the development of multidisciplinary teams to help patients with the CHD. Finally, we expect an increase in the regulatory burden and the cost of developing new treatments and diagnostics.
Key words: congenital heart defects, endovascular methods, open heart operations, minimally invasive interventions, critical heart defects.