Paediatric Cardiac Surgery and Europe: Today ́s Situation and Future Aspects

depending on the definition as geographical entity, economical or political union or as ethical, philosophical or cultural community referring to the historical occident, the term “europe” shows a wide spectrum of varieties . This is even true for regional medical systems and quality and structural availability of medical care and so even true for paediatric cardiac surgery . In western Europe, after decades of steadily improving performance on the base of an allinclusive social coverage, nowadays for nearly all CHD optimal treatment is guaranteed with low mortality rates and exceptionally good long term results . In (south)eastern Europe still major differences are present: there are regions with good conditions and – on the other side of reality – areas with no or no local care option . While in western Europe today there are too many surgical centres and surgeons with decreasing numbers of patients of native origin, in some regions in south-eastern Europe there is limitation in centres and trained surgeons for comparably more complex and not everywhere completely recorded children (and adults) with CHD . This presentation is to deal with options in supporting forced development of paediatric cardiac surgical care, especially in south-eastern Europe . Based on own experiences, the considerations will focus on various activities to improve the situation in Bosnia and Herzegovina and neighbouring countries . This analysis will deal with the evaluation of the reasonability of humanitarian projects, the option of cross-border cooperation and the prerequisites for long lasting care systems including the need for clear strategic political decisions within the health and insurance system .