Clinical analysis of 15 089 operations on the heart and great vessels. Results from the People's Republic of China

Abstract

Over a 28-year period, from November 1957 through November 1985, 15,089 patients underwent operations on the heart and great vessels at The Shanghai Chest Hospital. Herein we examine this experience, with particular attention to factors that affected mortality. Seven thousand two hundred eighty-one patients underwent procedures for mitral stenosis; 149 (2.0%) of these died. Two thousand one hundred thirty-three patients underwent closure of a patent ductus arteriosus; this procedure was associated with 9 deaths (0.4%), 5 of which were caused by massive hemorrhage. After 1964, over 98% of the procedures were accomplished with a locally-manufactured surgical stapler. This device allowed us to perform without any deaths a consecutive series of 1,838 patent ductus arteriosus closures from January 1970 to the end of our study. One thousand five hundred twnety-one patients underwent repair of a ventricular septal defect; 60 died, for a mortality rate of 3.9%. One thousand four hundred thirty-five patients had repair of an atrial septal defect; 13 died during or after operation, for a mortality rate of 0.9%. Higher mortality was observed in groups with severe pulmonary hypertension. Six hundred fifty-one patients were treated for pulmonary stenosis; 24 died, for an operative mortality of 3.7%. Five hundred eighty-five patients underwent total correction of tetralogy of Fallot; 100 died, for a mortality rate of 17.1%. Two hundred forty-seven patients with constrictive pericarditis underwent 250 pericardiectomies; 17 (6.9%) died during or after operation. Two hundred one patients had mitral or aortic valve insufficiency, or both. These patients underwent mitral, aortic, or double valve replacement; 30 died (14.9% mortality). One hundred eleven patients underwent aortic aneurysm resection; 24 died, for an operative mortality of 21.6%. This is 1 of the largest cardiovascular series ever reported from the People's Republic of China; therefore, it is a useful data base for study of cardiovascular surgical procedures and their results over a 3-decade period.