Introduction: Congenital Heart Disease (CHD) refers to structural or functional heart disease present at birth. CHD continues to cause morbidity and mortality in Fiji. There is no published data on CHD in the Pacific in the last 15 years. Unpublished data by Mataika. R, 2012 (12) estimated the incidence of CHD at Colonial War Memorial Hospital (CWMH) was ~ 0.5% or 4.9/1000 live births. This study aims to collect and document data on the incidence, types, management and outcomes of CHD, a platform upon which decisions for policy and practice development for CHD screening and management in Fiji can be made. Method: This is a five-year descriptive, retrospective, single-centre study at CWMH. Results: The incidence of CHD was 5.8 per 1,000 with an uncorrected incidence of 7.2 per 1,000. Ventricular Septal defects (VSD) and Tetralogy of Fallot (TOF) were the most common acyanotic and cyanotic lesions respectively. The total number of cases of CHDs was 202 and 76 (39%) died within that period. Ninety-five percent of the deaths occurred within the first year of life. Sixty-five percent of these infant mortalities were known acyanotic CHD cases. Forty-six (23%) cases had corrective surgeries. Survival rate for surgery locally was 98%, compared to 100% for those cases that had surgery abroad. Conclusion This study highlights the mortality associated with congenital heart diseases in Fiji and the need for strengthening of surgical management strategies.

Methods: We retrospectively reviewed the charts of consecutive patients who underwent one- or two-level ACDF using polyetheretherketone cages by multiple surgeons from January 2015 to June 2016. We excluded patients younger than 18 years old, patients who had prior surgery at the same level (s), those with two-stage procedures, and those with less than 3 months of followup. Fusion was determined using the “Song” criteria. Ordinal regression was used to determine predictors of fusion. Patient-reported outcomes (PRO) were analyzed. Results: We identified 323 consecutive patients. Twenty-two patients met the exclusion criteria. A total of 435 operative levels were included in the 301 remaining patients. Interspace fusion did not significantly vary by increasing interspace height with fusion rates between 76.2% and 82.8% at a mean follow-up of 17.9±12.6 months. The effect of an increase in interspace height and neck pain PRO was available for 163 patients who underwent one-level ACDF at a mean follow-up period of 16.2±13.1 months. We found no significant difference in fusion rate or neck pain score with increasing interspace height from 1 to 8 mm. Ordinal regression demonstrated no significant predictors of fusion. Conclusions Interspace distraction from 1 to 8 mm did not result in significantly different pseudarthrosis rates or postoperative neck pain.