Congenital heart defects in children treated free of charge

22.01.2024, 10:54

An agreement has been signed between the State Agency on Mandatory Health Insurance (the Agency) and Bona Dea Hospital Limited Liability Company to fund surgical operations for children born with congenital heart defects through the state budget.

Under the procurement agreement established through an open tender process, a total of 44 specialized medical services are offered for the treatment of congenital heart defects in children. These services include repair or replacement of heart valves, implantation and replacement of pacemakers, puncture, opening, and removal of the pericardial sac, reimplantation of the left and right coronary arteries from the pulmonary artery, minimally invasive balloon application for narrowing of the aorta, correction of atrial and ventricular septal defects using prostheses, oxygenation of blood in cases of acute heart failure, and other essential medical procedures.

Rules for Surgical Operations on Congenital Heart Defects

Children born with congenital heart defects must be referred by health facilities to the pediatric cardiology department of the Republican Children's Clinical Hospital. Following the examinations conducted in the department, a final diagnosis is established, and if there is a medical indication for surgery, a referral is issued to Bona Dea Hospital.

In cases requiring urgent surgical intervention, there is no need for referral to the Republican Children's Clinical Hospital. For emergency medical assistance, considering the condition and transportability of the newborn, the child should be transported directly to Bona Dea Hospital for surgery. This transport must be carried out in a mobile resuscitation unit equipped with an incubator and accompanied by a neonatologist and a nurse or midwife. An electronic request should then be sent to the responsible department of the Agency to finalize the diagnosis, determine the operation to be performed, and obtain the necessary approval.

It is important to note that the surgical treatment of congenital heart defects is also available at other private medical facilities contracted by the Agency under the Benefit Package of mandatory health insurance. However, six specific surgical procedures performed under the contract at Bona Dea Hospital are not included in the Benefit Package. Despite this, children born with congenital heart defects can still benefit from these cardiac operations free of charge, as timely detection of pathologies and surgical intervention are critical for preventing life-threatening situations.

№	*Description of services*
1	Open heart valvuloplasty of the aortic valve without replacement
2	Open heart valvuloplasty of the mitral valve without replacement
3	Open heart valvuloplasty of the pulmonary valve without replacement
4	Open heart valvuloplasty of the tricuspid valve without replacement
5	Aortic valve replacement with tissue graft, open or otherwise
6	Open and other replacement of the aortic valve
7	Mitral valve replacement with tissue graft, open or otherwise
8	Open and other replacement of the mitral valve
9	Pulmonary valve replacement with tissue graft, open or otherwise
10	Open and other replacement of the pulmonary valve
11	Replacement of the tricuspid valve with tissue graft, open or otherwise
12	Open and other replacement of the tricuspid valve
13	Operations on the mastoid muscle
14	Annuloplasty
15	Infundibulectomy
16	Operations performed on other structures besides heart valves (Valsalva sinus (aneurysm) repair)
17	Creating a septal defect in the heart
18	Restoration of auricular septal defect with prosthesis, open method
19	Restoration of auricular septal defect with prosthesis, closed method
20	Restoration of intragastric septal defect with prosthesis, open method
21	Restoration of the complete form of the atrioventricular septal defect with a prosthesis
22	Reconstruction of intragastric septal defect with prosthesis, closed method
23	Reconstruction of persistent atrio-ventricular canal defect with tissue graft
24	Revision of the heart correction procedure (Replacement of the tubular prosthetic heart valve. Re-stitching of the septum and/or valve)
25	Percutaneous balloon valvuloplasty
26	Pericardiotomy
27	Pericardiectomy
28	Cardiomyostimulation system implantation
29	Implantation of a permanent pacemaker, primary or replacement, type of device not specified
30	System–pulmonary artery shunt (B-T shunt)
31	Vena cava – pulmonary artery anastomosis (Glenn)
32	Aorta-subclavian-carotid "bypass" (shunt)
33	Examination (diagnostic) thoracotomy (Exploratory sternotomy)
34	Surgical closure (ligation) of patent arterial duct (PDA)
35	Invasive closure of patent arterial duct (PDA).
36	Surgical removal of coarctation of the aorta
37	Pulmonary artery banding surgery
38	Ross operation
39	Surgical elimination of aorto-pulmonary window defect
40	Assisted extracorporeal circulation for open heart surgery (for cases without extracorporeal circulation)
41	Extracorporeal membrane oxygenation [ECMO - ECMO]
42	Percutaneous cardiopulmonary bypass (for cases without percutaneous cardiopulmonary bypass)
43	Invasive balloon angioplasty of aortic coarctation
44	Other operations performed on heart vessels (total correction of ALCAPA or ARCAPA defect)