Shifts in inpatient treatment patterns for congenital heart disease before and after the introduction of open - heart surgery at Hanoi Medical University Hospital (2015 - 2024)

Tóm tắt

Congenital heart defect (CHD) refers to structural abnormalities of the heart occurring during fetal development that require diagnosis and treatment regardless of age. Since 2019, the Center of Cardiovascular Diseases at Hanoi Medical University Hospital (HMUH), a leading center for CHD interventional treatment in northern Vietnam, has implemented open-heart surgery, marking a shift in treatment patterns. This study aims to investigate the shifts in the pattern of CHD treatment among inpatients at HMUH from 2015 to 2024 with the introduction of open-heart surgery. A cross-sectional study included 711 inpatients, divided into two phases: Phase 1 (2015 – 2019), pre- surgery (235 patients); Phase 2 (2019 – 2024), post- surgery (476 patients). In Phase 2, the mean age of patients increased significantly (34.6 ± 19.7 years old vs. 27.1 ± 20.7 years old, p < 0.001). The proportions of CHD types demonstrated a significant shift, with more atrial septal defect (ASD) (64.9% vs. 51.1%), fewer proportion of ventricular septal defect (VSD) (5.9% vs. 17%), and the emergence of complex anomalies, including atrioventricular septal defect (AVSD), tetralogy of Fallot (ToF), and coarctation of the aorta (CoA) (p < 0.001). Regarding treatment approach, 41 patients (8.6%) underwent surgical repair, and 3 patients (0.7%) received hybrid intervention. The treatment success rate declined slightly (88.9% vs.93.6%), while complications and residual shunts increased (p < 0.05). Overall, open-heart surgery expanded treatment capacity and altered CHD patterns at HMUH.