Congenital and Rheumatic Heart Disease in the South Pacific: An Urgent Need for a Regional Cardiac Surgery Center.

The island nations of the South Pacific are home to more than 3 million Polynesians and Melanesians. There is a high birthrate and unique susceptibility to rheumatic fever which together have led to a large and increasing population of children and young adults with both congenital and rheumatic heart disease. Wide geographic dispersal has resulted in major challenges in both diagnosis and management of these patients. Volunteer medical and surgical teams have carried much of the load until now, supported by generous donations from numerous countries and religious foundations. Expensive referral to centers in Australia and New Zealand has been needed for complex patients. However, the changing landscape of international aid and evolving geopolitical tensions threaten the traditional paradigm. In this setting there is an urgent need for a regionally funded, centrally located, locally administered cardiac center to coordinate training of healthcare professionals as well as providing the medical and surgical care of children and adults with congenital and rheumatic heart disease throughout the South Pacific.