Heart surgery over two decades: what we have learned about results and changing risks

Area of Science:

• Cardiovascular Surgery
• Public Health
• Epidemiology

Background:

• Cardiac surgery databases are crucial for enhancing patient care quality in referral centers.
• Tehran Heart Center (THC), a major cardiovascular referral center, has collected comprehensive patient data since 2001.

Purpose of the Study:

• To analyze 20-year trends (2002-2021) in cardiovascular risk factors (CVRFs) and surgical procedures among cardiac surgery patients at THC.
• To evaluate CVRFs and in-hospital mortality across different cardiac surgery types.

Main Methods:

• A serial cross-sectional study analyzed data from 54,418 cardiac surgery patients at THC.
• Included isolated coronary artery bypass graft (CABG), isolated valve surgeries, and combined CABG+valve procedures.
• Excluded miscellaneous surgeries (N=9,556).

Main Results:

• Isolated CABG was the most frequent procedure (84.5%).
• A consistent rising trend in CVRFs was observed across all surgical groups from 2002 to 2021.
• In-hospital mortality ranged from 2.0% in 2001 to a high of 4.0% in 2020.

Conclusions:

• Increasing cardiovascular risk factors present a significant challenge in cardiac surgery patients.
• These findings underscore the need for adaptive clinical management and policy adjustments.
• The study highlights the importance of continuous data monitoring in cardiac surgery centers.