Heart surgery for children in Northern Ireland looks set to end after a review said it would not be safe to carry out such operations in the future.
An expert panel has said there are no immediate safety concerns, but warned the service is not sustainable in the long-term.
This is because of the small number of operations being carried out and the level of expertise required.
In Northern Ireland, only around 90 paediatric cardiac surgical operations are carried out each year, with a further 40 in England or Dublin.
Health Minister Edwin Poots said the review panel has told him the issue must be addressed within six months.
The development — which could mean babies and their families travelling to Dublin or England for life-saving heart surgery — has been met with dismay by parents.
Eamon McLoughlin, from Omagh, said: “My son Cathal, who is now seven years old, was born with Down’s syndrome and very quickly we realised he had a heart condition as well.
“At the time we were told he would need surgery but he was too weak, so we waited until he was about one before he went for the surgery. Everything went well but about a year later he became ill again and was admitted to the Erne Hospital.
“His condition deteriorated and he was rushed up to the Children’s Hospital in Belfast.
“We know we owe his life to the team at Belfast. They saved him on both occasions.”
Mr McLoughlin said he is extremely distressed that the family may have to travel outside of Northern Ireland in future for their son to get treatment.
“I can’t imagine how we would cope if we had to go to Dublin or somewhere in England.
“Cathal is OK, but he is going to need more surgery in future. We’re devastated by this news.”
Leading charity Children’s Heartbeat Trust has also expressed concern over the possible reduction in services in Belfast.
Sarah Quinlan, the organisation’s executive officer, said: “This is a very worrying development for our parents.
“It is imperative that the local service is retained.”
Ms Quinlan also raised concerns over the findings of the review: “The report recognises that there are no safety concerns over the Belfast service but then says that there is a potential safety risk within six months.
“This is alarmist and contradictory,” she added.
Health Minister Edwin Poots has asked the Health & Social Care Board to establish a working group to make proposals on how best to deliver cardiac services for children living in Northern Ireland.
The group will be made up of patient representatives, parents and doctors.
A public consultation will be carried out before any changes are made, which is expected to begin in September.