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. 2021 Nov 23;21(1):521.
doi: 10.1186/s12887-021-02935-2.

Characteristics of in-hospital mortality of congenital heart disease (CHD) after surgical treatment in children from 2005 to 2017: a single-center experience

Guilang Zheng #  1 , Jiaxing Wu #  1 , Peiling Chen  1 , Yan Hu  1 , Huiqiong Zhang  1 , Jing Wang  1 , Hanshi Zeng  1 , Xufeng Li  1 , Yueyu Sun  1 , Gang Xu  2 , Shusheng Wen  2 , Jianzheng Cen  2 , Jimei Chen  3 , Yuxiong Guo  4 , Jian Zhuang  5
Affiliations

Characteristics of in-hospital mortality of congenital heart disease (CHD) after surgical treatment in children from 2005 to 2017: a single-center experience

Guilang Zheng et al. BMC Pediatr. .

Abstract

Background: To evaluate trends in the in-hospital mortality rate for pediatric cardiac surgery procedures between 2005 and 2017 in our center, and to discuss the mortality characteristics of children's CHD after thoracotomy.

Methods: This retrospective data were collected from medical records of children underwent CHD surgery between 2005 and 2017.

Results: A total of 19,114 children with CHD underwent surgery and 444 children died, with the in-hospital mortality was 2.3%. Complex mixed defect CHD had the highest fatality rate (8.63%), left obstructive lesion CHD had the second highest fatality rate (4.49%), right to left shunt CHD had the third highest mortality rate (3.51%), left to right shunt CHD had the lowest mortality rate (χ2 = 520.3,P < 0.05). The neonatal period has the highest mortality rate (12.17%), followed by infant mortality (2.58%), toddler age mortality (1.16%), and preschool age mortality (0.94%), the school age and adolescent mortality rate was the lowest (χ2 = 529.3,P < 0.05). In addition, the fatality rate in boys was significantly higher than that in girls (2.77% versus 1.62%, χ2 = 26.4, P < 0.05).

Conclusions: The mortality rate of CHD surgery in children decreased year by year. The younger the age and the more complicated the cyanotic heart disease, the higher the mortality rate may be.

Keywords: Congenital heart disease; Epidemiology; In-hospital mortality; Pediatric cardiac surgery.

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Conflict of interest statement

All authors stated no potential conflicts exist.

Figures

Fig. 1
Fig. 1
Patient flow chart. Group A: left to right shunt CHD; Group B: left obstructive lesion CHD; Group C: right to left shunt CHD; Group D: complex mixed defect CHD; Group E: other CHD. Reasons for exclusion (F) were portal vein-hepatic artery fistula (1 case), atrial benign tumor (8 cases), infectious endocarditis with neoplasms (32 cases), prolonged (chronic) myocarditis (1 case), persistent fetal circulation (1 case), constrictive pericarditis (1 case), atrial thrombus (1 case), congenital paralysis (1 case), ascending aortic aneurysm (1 case), endometrial fibrosis (1 case), third-degree atrioventricular block (1 case), explosive myocarditis (2 cases), and mediastinal benign tumors (1 case)
Fig. 2
Fig. 2
Annual operation volume for CHD and the cyanotic CHD proportion in children below 14 years old from 2005 to 2017. Chart a shows the annual cases of surgery for right-to-left shunt CHD, complex mixed defect CHD and total cyanotic CHD from 2005 to 2017. Chart b demonstrates the cyanotic CHD proportion (of total CHD in children below 14 years old) from 2005 to 2017
Fig. 3
Fig. 3
Distribution of CHD surgery mortality in children from 2005 to 2017. Chart a shows the mortality of different CHD disease types. Chart b shows the mortality of children at different ages. Chart c shows the mortality of CHD children by sex
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