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. 2024 Apr 5;24(1):195.
doi: 10.1186/s12872-024-03860-9.

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

Masih Tajdini  1 , Amir Hossein Behnoush  1   2 , Mina Pashang  1   2 , Mana Jameie  1   2 , Amirmohammad Khalaji  1   2 , Saeed Sadeghian  1   2 , Ali Vasheghani-Farahani  1   2 , Hamidreza Poorhosseini  1   2 , Farzad Masoudkabir  1   2 , Kaveh Hosseini  1   2 , Saeed Davoodi  1   2 , Mohammad Sahebjam  1   2 , Khosro Barkhordari  1   2 , Haleh Ashraf  1   2 , Akbar Shafiei  1   2 , Abbasali Karimi  3   4 ; T. H. C. Surgery Databank Collaborators
Collaborators, Affiliations

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

Masih Tajdini et al. BMC Cardiovasc Disord. .

Abstract

Objectives: Using the cardiac surgery database is of high importance in referral centers and can lead to a better quality of care for patients. Tehran Heart Center (THC) is a cardiovascular referral center that was inaugurated in 2001. In this report, we aimed to present the third report of trends in patients' cardiovascular risk factors and surgical procedures from 2002 to 2021 that have been gathered for all THC patients.

Methods: This serial cross-sectional study was conducted at Tehran Heart Center from 2002 to 2021. All patients undergoing cardiac surgeries were eligible to enter the study (N = 63,974). Those with miscellaneous types of surgeries were excluded (N = 9556). The distribution of cardiac surgeries (including isolated coronary artery bypass graft (CABG), isolated valve, and CABG + valve surgeries) and their respective in-hospital mortality were recorded. Furthermore, 20-year trends in the prevalence of various cardiovascular risk factors (CVRFs) among the following groups were evaluated: a) isolated CABG, b) aortic valve replacement/repair for aortic stenosis (AS/AVR/r), and c) isolated other valve surgeries (IVS).

Results: A total of 54,418 patients (male: 70.7%, age: 62.7 ± 10.8 years) comprised the final study population, with 84.5% prevalence of isolated CABG. Overall, the AS/AVR/r group was in between the CABG and IVS groups concerning CVRFs distribution. Excluding some exceptions for the AS/AVR/r group (in which the small sample size (N = 909) precluded observing a clear trend), all studied CVRFs demonstrated an overall rising trend from 2002 to 2021 in all three groups. Regarding in-hospital mortality, the highest rate was recorded as 4.0% in 2020, while the lowest rate was 2.0% in 2001.

Conclusions: Isolated CABG remained the most frequent procedure in THC. Notable, increasing trends in CVRFs were observed during this 20-year period and across various types of cardiac surgeries, which highlights the clinical and policy-making implications of our findings.

Keywords: Cardiac Surgery; Developing Countries; Iran; Tehran Heart Center; Trend.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Twenty-year trends of cardiac surgeries A) Total and B) Valve surgeries
Fig. 3
Fig. 3
Twenty-year trends of cardiovascular risk factors according to cardiac surgery types A) Diabetes, B) Hypertension, C) Current cigarette smoking, D) Opium ever use, E) Age, F) LVEF ≤ 40, and G) BMI ≥ 30
Fig. 4
Fig. 4
Twenty-year trends of in-hospital mortality among cardiac surgeries A) Total and B) Classified
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