Related Experiment Videos
Evolution of surgical trends in congenital heart disease: a population based study
1St. Lukes Hospital, Guardamangia, Malta. victor.egrech@magnet.mt
Insights
Surgical trends for congenital heart disease show an increase in complex operations performed at younger ages with reduced mortality. This advancement in pediatric cardiac surgery comes with significant financial implications.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Public Health
Background:
- Congenital heart disease (CHD) necessitates specialized surgical interventions.
- Understanding historical surgical trends is crucial for future healthcare planning and resource allocation.
Purpose of the Study:
- To analyze surgical trends for congenital heart disease in Malta from 1947 to 1997.
- To examine changes in types of operations, patient age at surgery, and mortality rates.
Main Methods:
- Population-based study including all CHD patients born and operated on in Malta.
- Analysis of surgical data including lesion types, age at operation, and perioperative mortality.
- Calculated surgical rates per 1000 live births for specific periods.
Main Results:
- Significant increase in the proportion of complex cardiac malformations operated on (P<0.001).
- Operations performed at progressively younger ages (P<0.001).
- Declining perioperative mortality rates observed (P<0.001).
Conclusions:
- Congenital heart disease surgery has become more aggressive and safer over the study period.
- Increased surgical volume and complexity require substantial financial investment.
- Future trends may be influenced by evolving surgical techniques and healthcare costs.
Abstract:
The aim of this study was to establish surgical trends in patients with congenital heart disease operated on between 1947 and 1997 in a population based study. All patients diagnosed as having congenital heart disease, born in Malta up to 1995 inclusive and operated for congenital heart disease up to 1997 inclusive were included. Analysis was carried out for lesions operated, age at surgery, operative centre and mortality rates, in the setting of a regional hospital providing congenital heart disease diagnostic and follow-up services for all Malta. Increasingly more operations for cardiac malformations are being carried out, with a progressively higher proportion of operations performed on complex conditions (P<0.001), at an ever younger age (P<0.001), and with a declining perioperative mortality (P<0.001). For the period 1990-1994, 4.2 operations for congenital heart disease/1000 live births were required. Factors which may increase or decrease this rate in future are discussed, along with costs of surgery. Surgery for congenital heart disease has become progressively more aggressive and safer since this method of treatment for these malformations was initiated, but this has occurred at a significant financial cost.