0095: Fate and evolution of patients with congenital heart disease: Moroccan experience

Abstract

Congenital heart disease are frequent and often severe. Their surgical treatment restores the closest possible physiological function. In Under-developing countries, the therapeutic management of these heart disease is limited by the lack of resources and skills. The objective of this work was to study the fate of patients in whom the indication for surgery was raised A retrospective descriptive study conducted at the University Hospital of Casablanca over 5 years (décember 2008 to décember 2013). We have collected 1908 patients with congenital heart disease, 738 (38.7%) had a surgical indication. 50% of patients were operated, 22.6% non-operated. In patients operated, the median age of surgery: 3 years [6days-51years], the median time between diagnosis and surgery: 4months [9days-5yrs]. It was a IVC (30%) and a IAC (20.4%). Favorable evolution in82.9%. Death occurred in15, 2% which 62.5% immediatly in postoperative period. Mortality varied with the centre (18% for patients operated in UHC and 24% privately center and 3.4% in abroad). In non-operated patients, 50%were due to lack of funds, 34.3% awaiting a surgical date and15.7% refused surgery. 34.5% of non-operated patients died. The quality of life of survival patients is affected in 68% in terms of physical health, and 76%of patients had mental health degradation. Although the indication for surgery of congenital heart disease is a medical necessity, the outcome of these patients in Moroccan context depends on several technical and affordability considerations. This results in a high mortality rate and also adult carriers of congenital heart disease with impaired quality of life.