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2015年和2016年日本心血管外科现状:基于日本心血管外科数据库的报告。1-先天性心脏病手术

Current status of cardiovascular surgery in Japan, 2015 and 2016: a report based on the Japan Cardiovascular Surgery Database. 1-congenital heart surgery.

作者信息

Hirata Yasutaka, Hirahara Norimichi, Murakami Arata, Motomura Noboru, Miyata Hiroaki, Takamoto Shinichi

机构信息

Department of Cardiac Surgery, The University of Tokyo School of Medicine, Tokyo, Japan.

JCVSD C/O The Japan Society for Cardiovascular Surgery, 2-26-9 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2019 Sep;67(9):731-735. doi: 10.1007/s11748-019-01160-0. Epub 2019 Jul 20.

Abstract

OBJECTIVES

We analyzed the mortality and morbidity of congenital heart surgery in Japan by using Japan Cardiovascular Surgery Database (JCVSD).

METHODS

The data on congenital heart surgery performed between January 2015 and December 2016 were obtained from JCVSD. From the data obtained, the most frequent 20 procedures were selected, and the mortalities and major morbidities were analyzed. In addition, the institutions were classified into three groups according to the number of cardiopulmonary cases for a year, and the distribution of the major operations was calculated.

RESULTS

The mortality of ASD repair and VSD repair was under 1% and the mortality of TOF repair, complete AVSD repair, Rastelli operation, CoA complex repair, bidirectional Glenn and TCPC was 2-3%. The mortality of Norwood procedure and TAPVC repair were over 10%. These difficult operations were mainly performed at relatively high-volume institutions.

CONCLUSION

Using the data from JCVSD, the national data of congenital heart surgery, including postoperative complications, were analyzed. Neonatal surgery still has considerable complication rates and further improvement is desired. In addition, it was shown that complicated operations tended to be performed at large volume institutions.

摘要

目的

我们通过使用日本心血管外科数据库(JCVSD)分析了日本先天性心脏病手术的死亡率和发病率。

方法

从JCVSD获取2015年1月至2016年12月期间进行的先天性心脏病手术数据。从获得的数据中,选择最常见的20种手术,并分析死亡率和主要发病率。此外,根据一年内心肺病例数将机构分为三组,并计算主要手术的分布情况。

结果

房间隔缺损修补术和室间隔缺损修补术的死亡率低于1%,法洛四联症修补术、完全性房室通道修补术、Rastelli手术、主动脉缩窄复杂修补术、双向格林手术和全腔静脉肺动脉连接术的死亡率为2%-3%。诺伍德手术和完全性肺静脉异位连接修补术的死亡率超过10%。这些难度较大的手术主要在手术量相对较大的机构进行。

结论

利用JCVSD的数据,对包括术后并发症在内的先天性心脏病手术全国数据进行了分析。新生儿手术的并发症发生率仍然相当高,需要进一步改善。此外,结果表明复杂手术倾向于在手术量大的机构进行。

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