Five-year experience with congenital cardiac surgery at National University Heart Centre, Singapore

Kang GS, Soh YF, Kofidis T, Lee CN
Correspondence: Dr Kang Giap Swee, kangzilun@yahoo.com

ABSTRACT
Introduction Surgical procedures performed for congenital heart disease are usually complex and variable. The aims of this paper were to analyse patient demographics in a centre that caters to congenital cardiac surgery, compare departmental standards to international centres, and investigate the relationship between patient volume and clinical outcome.
Methods A total of 163 patients who presented to the Cardiac, Thoracic and Vascular Surgery Department of the National University Hospital, Singapore between 2002 and 2006 were identified and studied retrospectively. Patient demographics were analysed. The mortality rates and patient volume were compared with those observed at international centres.
Results The mean annual patient volume was 32.6 cases. The mean age of the patients was 15.7 years, with the oldest patient being 73 years old. 57.1 percent of the patients were Chinese, 23.3 percent were Malay and 19.6 percent were Indian and other races. Foreigners made up nearly half of the patient cohort (45.4 percent). Atrial septal defect was found to be the most common diagnosis (n is 64), with the secundum being most commonly involved (76.9 percent). The commonest postoperative morbidities encountered were arrhythmias and pleural effusions. Patient volume was not found to be a significant factor affecting clinical outcomes.
Conclusion With a growing population of adults with congenital heart disease and a significant number of foreign patients, improvements to our resources and infrastructure need to be considered in order to cope with the increasing demands. Despite having a low patient volume, the centre is still able to provide congenital heart surgery with good clinical outcomes that are comparable to those of international centres with similar or higher patient volumes.

Keywords: clinical outcomes, congenital cardiac surgery, congenital heart disease, patient volume
Singapore Med J 2010; 51(7): 570-575