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About pediatric cardiology

Pediatric cardiology has undoubtedly experienced a dynamic rise throughout the world, especially in developed countries, over the last three decades.

Although in difficult conditions, it has achieved significant progress here, which is reflected in several basic features:

  • The profession is centralized and the majority of patients with congenital heart defects and other complex heart diseases gravitate towards the newly formed Reference Center for Pediatric Cardiology, which works with the Department of Pediatric Cardiology of the KBC Pediatric Clinic, Rebro.
  • It is about extensive team work that is coordinated by cooperation on several levels: fetal cardiology, cooperation with obstetricians, prescribed patient transport, excellent care in intensive care units and in neonatology, early diagnostics and, if necessary, interventional diagnostics, correct decision on the type and speed of surgery, surgery with special knowledge related to small children, which also includes special anesthesia, perfusion and transfusion in order to after that, the child ended up in the intensive care unit, where he is taken out of crisis and any complications are taken care of.
  • We've gone deep into fetal age, so the development of fetal cardiology is of crucial importance for joining modern tendencies, and this means that we have embarked on serious ethical considerations about the beginnings of life and the fetus as a human being.
  • We have not yet addressed our need for the development of guidelines in the area called the treatment of congenital heart defects in adults (so-called GUCH - grow up congenital heart).
  • It should be emphasized that complications after surgery, late complications, as well as electrostimulation, are a further concern of pediatric cardiologists. Regardless of all the difficulties we have had in the last two decades since the liberation of Croatia, we believe that the good development of pediatric cardiology has had a positive impact on the perinatal mortality curve.
  • Given the increasing number of survivors of childhood heart disease and their transition to adulthood, an unexpected public health problem has emerged, manifested in the increasing number of chronic patients with heart disease resulting from good treatment of congenital heart defects and cardiomyopathies. It includes the need for professional orientation and the development of principles according to which these patients should be equally included in social life..

From 1996 to 2009, 2379 cardiac catheterizations were performed in children of both sexes (51% male and 49% female), of which 530 were interventional procedures (22.3%).

Among the special advances in the treatment of cardiomyopathies in pediatrics, we consider the introduction of ECMO support, which has been used in our Clinic for the past 2 years, and the beginning of heart transplantation in children. The first such transplantation was successfully performed in 2011 in an 11-year-old girl with severe postmyocarditic dilated cardiomyopathy.

WRITTEN BY:

prof. dr. sc. Ivan Malčić, dr. Hrvoje Kniewald, prim. dr. Dalibor Šarić, dr. sc. Daniel Dilber, dr. Dorotea Bartoniček
Clinic for Pediatrics, Department of Pediatric Cardiology, KBC Zagreb, Zagreb-Rebro, Croatia