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Review of coronary artery surgery in China
1Department of Cardiovascular Surgery, Fu Wai Heart Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Coronary artery bypass grafting in China has advanced significantly, with over 1000 procedures by 1998 and decreasing mortality rates. Patient profiles are shifting, and new techniques like off-pump surgery show promise.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Medical Technology
Background:
- Coronary artery bypass grafting (CABG) in China has a 30-year history, with accelerated development in the last decade.
- National CABG procedures increased from approximately 100 in 1994 to over 1000 by 1998.
- Mortality rates for CABG have shown a significant downward trend.
Purpose of the Study:
- To review the development and outcomes of coronary artery surgery in China over 30 years.
- To analyze trends in surgical techniques and patient demographics.
- To assess the early results of novel surgical approaches.
Main Methods:
- Retrospective analysis of national coronary artery surgery data.
- Review of surgical practices and outcomes at Fu Wai Hospital, Beijing.
- Examination of patient profile changes over time.
Main Results:
- Mortality rates for CABG halved between 1992 and 1993, falling below 1% at Fu Wai Hospital by 1998.
- The left internal mammary artery was the preferred graft in 65% of cases in 1995.
- Increasing incidence of hypertension and diabetes, with decreasing severe ventricular dysfunction in patients.
Conclusions:
- Coronary artery surgery in China has demonstrated substantial progress in volume and safety.
- Evolving patient demographics present new challenges and considerations for surgical management.
- Introduction of off-pump and minimally invasive CABG in 1996 indicates a move towards advanced surgical techniques.
Abstract:
The 30-year history of coronary artery surgery in China has shown rapid development, particularly in the past 10 years. By 1994, approximately 100 coronary bypass grafting procedures were performed nationally, with mortality rates halving between 1992 and 1993. By 1998, more than 1000 operations had been performed, with mortality rates falling to less than 1% at Fu Wai Hospital, Beijing, but with varying results across the country. Figures for 1995 from Fu Wai Hospital show that the use of the left internal mammary artery was favoured in 65% of patients, with the radial artery used in less than 10%. Changes to the presenting patient profiles have been noted across time, with the incidence of hypertension and diabetes increasing and with severe ventricular dysfunction decreasing. Off-pump and minimally invasive coronary artery bypass grafting were introduced to China in 1996 with encouraging early results.
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