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Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Status of paediatric cardiac surgery in China
1Shanghai Children's Medical Center, Shanghai Second Medical University, China.
Insights
Annually, 100,000 Chinese neonates have congenital heart disease, but only 20% receive surgery. Surgical access and quality vary significantly across China, particularly between urban and rural regions.
Area of Science:
- Pediatric Cardiac Surgery
- Epidemiology
- Public Health
Background:
- Congenital heart disease (CHD) affects approximately 100,000 neonates annually in China, matching international incidence rates.
- Surgical intervention for CHD is accessible to only about one-fifth of affected neonates.
- Significant disparities exist in surgical access, with urban coastal areas offering better availability than rural interior regions.
Purpose of the Study:
- To analyze the current landscape of pediatric cardiac surgery in China.
- To assess the accessibility and quality of surgical treatments for congenital heart disease across different regions.
- To identify areas for quality improvement in pediatric cardiac surgery outcomes.
Main Methods:
- Review of epidemiological data on congenital heart disease incidence in China.
- Analysis of surgical procedure volumes and facility distribution.
- Comparative assessment of treatment quality based on procedure type and geographical location.
Main Results:
- Over 30,000 pediatric cardiac surgeries are performed annually across 300 facilities in China.
- Major centers like Fu Wei Hospital and Shanghai Children's Medical Centre perform over 1000 procedures each year.
- While Tetralogy of Fallot correction outcomes meet international standards (1.1-5% mortality), other complex procedures show ongoing quality improvement needs.
Conclusions:
- Despite improvements since the 1970s, pediatric cardiac surgery in China faces challenges in equitable access and consistent quality.
- Further development is crucial, especially for severe and complex congenital heart defects, to enhance patient outcomes nationwide.
Abstract:
Epidemiological data show that in China, approximately 100,000 neonates annually are born with congenital heart disease, an incidence equivalent to that found internationally. However, surgical treatment is available to only one-fifth of these individuals. Access to surgery is generally becoming more readily available in the urbanised coastal areas than in the rural interior. Over 1000 procedures annually are performed at the two largest facilities, the Fu Wei Hospital, Beijing, and the Shangai Children's Medical Centre. The 300 paediatric cardiac surgery facilities across China perform approximately 30,000 operations each year, with the quality of treatment varying according to location and procedure type: data on Tetralogy of Fallot correction, for example, show that standards are equivalent to those seen internationally, with a mortality rate of 1.1-5%. For other procedures, although outcomes have improved since the beginnings of Chinese paediatric cardiac surgery in the 1970s, there is still a process of quality improvement, especially for the more severe and complex disorders.
