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Surgical treatment for severe congenital heart diseases
Insights
Surgical outcomes for severe congenital heart disease (CHD) show improvement, though mortality remains high for infants under three months. Further research is needed to enhance surgical results for newborns and very young infants with CHD.
Area of Science:
- Cardiology
- Pediatric Surgery
- Congenital Heart Disease
Background:
- Severe congenital heart disease (CHD) necessitates complex surgical interventions.
- Surgical outcomes for CHD have historically varied significantly based on defect type and patient age.
Purpose of the Study:
- To analyze surgical results for severe congenital heart disease patients treated between 1978 and 1981.
- To identify specific CHDs with higher surgical mortality rates.
- To highlight the need for improved surgical techniques in neonates and infants.
Main Methods:
- Retrospective analysis of surgical data from the National Cardiovascular Center, Japan.
- Categorization of surgical outcomes by specific congenital heart defect types.
- Calculation of surgical mortality rates for different conditions.
Main Results:
- Mortality rates varied widely: 1.1% for Tetralogy of Fallot to 44% for Total Anomalous Pulmonary Venous Return.
- Ventricular septal defect with pulmonary hypertension in patients under 2 years had a 4% mortality rate.
- Congenital heart defects requiring early surgical intervention (under 3 months) presented the greatest challenge.
Conclusions:
- Surgical results for congenital heart disease have shown improvement over time.
- Significant challenges persist for surgical interventions in newborns and infants under three months.
- Continued efforts are crucial to enhance surgical outcomes for the youngest and most vulnerable CHD patients.
Abstract:
The surgical results in patients with severe congenital heart disease, who underwent surgical treatment between 1978 and 1981 at the National Cardiovascular Center, Japan, were analyzed. The surgical mortality rates were 4% for cases of ventricular septal defect associated with pulmonary hypertension in patients under 2 years of age, 16.7% for complete atrio-ventricular canal, 11% for coarctation of the aorta associated with ventricular septal defect, 40% for pure pulmonary atresia without Ebstein anomaly, 44% for total anomalous pulmonary venous return, 14.8% for transposition of the great arteries, 44% for double outlet right ventricle and 1.1% for tetralogy of Fallot. The surgical results have been improving and postoperative residua and sequelae have been decreasing through our persistent efforts. Today's main problem is a relatively poor performance in cases which need surgical intervention early in life, i.e., under 3 months of age. Therefore, we think that our effort to improve the surgical results for new-borns or very young infants is most necessary.