Comprehensive program development for congenital heart disease in the United Arab Emirates and in Singapore

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Published: Sep 8, 2023
DOI: https://doi.org/10.12681/jhcvm.34673
Keywords:
cardiac surgery Humanitarian, Critical Congenital Heart Diseases, Prevalence
Laszlo Kiraly
National University Hospital Singapore
Maung Maung Winn Aye
National University Hospital Singapore
Senthil Kumar Subbian
National University Hospital Singapore
Nishant Chandrakant Shah
Sheikh Kalifa Medical City
Balazs Hetharsi
Aref Mohammed Al Hakami
Theo Kofidis
National University Hospital Singapore
Abstract

Background/Objective. Establishment and development of tertiary-care centres for congenital heart disease (CHD) face multiple challenges as they need to be accessible, affordable/sustainable and provide the best possible outcomes. We report our experience of foundation a new tertiary-care CHD centre in the United Arab Emirates (UAE) and program development in Singapore.


Methods. Prevalence and incidence of CHD in the context of local sociocultural environment was reviewed. Having established program elements of team, premises and workflow, quality assurance system was established. Outcome analysis, continuous audit modified internal therapeutic policies in accordance to international databases.


Results. Consanguinity, segregated pattern of the population, high birth rate and low prenatal screening rate increased the incidence/prevalence and complexity of CHD in the UAE. Higher complexity/redo presentation and presence of associated anomalies were prevalent in Singapore at a lower birth rate. Increasing patient-load, strict professional working environment, strong governmental financial mandate for care nominated our centre into a market-leading position in the UAE. Singapore has a highly-developed, regulated, still competitive healthcare infrastructure that represents challenges for program development. Additional surgical activity from underserviced regions could provide the adequate CHD patient-pool that is critical to achieve team-expertise and ensure the best possible patient and program outcomes.


Conclusion. CHD has significant public health aspects, however, new and/or developing centres face different challenges depending on the sociocultural and economic environment they function in. External demographic factors, case-load, complexity, referral patterns, health-care financing structure are difficult to adjust; internal factors: program structure, quality assurance, professional working framework are subjects for improvement.

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Author Biographies
Laszlo Kiraly, National University Hospital Singapore

Professor, Division Chief, Pediatric cArdiac Surgery, CTVS, NUHCS

ORCID ID: 0000-0002-3193-9753

Senthil Kumar Subbian, National University Hospital Singapore

Consultant Pediatric Cardiac Surgery

Nishant Chandrakant Shah, Sheikh Kalifa Medical City

Consultant Pediatric Cardiology, SKMC

Balazs Hetharsi

Consultatn, Critical Care, SKMC

Aref Mohammed Al Hakami

Consultant, Pediatric Cardiology, SKMC

Theo Kofidis, National University Hospital Singapore

Professor, Chair of Department, CTVS, NUHCS

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