Adult and Paediatric Cardiac Intervention in Timor-Leste: Disease Burden, Demographics and Clinical Outcomes.

Background: The East Timor Hearts Fund (ETHF) is a charitable organisation involving Australian cardiologists who provide outreach screening in Timor-Leste, and cardiac interventions in Australia/New Zealand. Method(s): The ETHF database was utilised to identify patients with disease warranting surgical or percutaneous intervention. Overall demographics and pre- and post-operative factors were assessed, with sub-group analysis of adult and paediatric patients to identify any differences in care. Result(s): Of 221 patients requiring intervention, 101 patients received intervention. Patients were predominantly young (median age 17.5 years) and female (64.7%), with rheumatic heart disease (63.8%). 24 (33.3%) women aged 15-45yo were documented as pregnant with severe cardiac disease. Of patients not proceeding to intervention, adults were more likely to be lost to follow-up (42.4% vs 18.5%) while paediatric patients were more likely to experience progression of disease (18.5% vs 7.5%, p = 0.005). Median waitlist time was 5 months, with no difference between adults and children, correlating with pre-operative mortality of 5.4%. Post-procedure mortality was extremely low (0.9%) and attendance of at least one post-procedure review excellent (99.0%). 11 (10.9%) patients have required repeat intervention, with no difference in rates between adult and paediatric patients. Conclusion(s): The Timor-Leste interventional cohort are predominantly a young female population with rheumatic and congenital cardiac disease. Delayed access to intervention may result in pre-operative adverse events and mortality, and is a key target for improvement. Patients who undergo surgery have very low post-procedural mortality, excellent adherence to medical follow-up and good long-term outcomes.Copyright © 2019