Annual Report of Cardiovascular Surgery 2010

Nagasaki University
2010.1～2010.12

1. Overall
Ⅰ. Number of Operations and Surgical Mortality
Ⅱ. Mode of Operation
Ⅲ. Age Distribution

Page233

2. Summary of CardioVascular Division
Ⅰ. Number of Operations and Surgical Mortality
Ⅱ. Valvular Heart Disease
Ⅲ. Ischemic Heart Disease
Ⅳ. Congenital Heart Disease
Ⅴ Others
Ⅴ.
Ⅵ. Maze operation
Ⅵ. Vascular Disease

45799910

3. Summary of Hospital Deaths12

～Overall～Ⅰ. Number of Operations and Surgical mortality
Division

No.
Cases

No. OP.

OP. mortality (%)

Hosp. mortality (%)

CardiacThoracic

1634316443

1 (0.6)2 (4.6)

1 (0.6)4 (9.3)

Car. + Thoracic

111100

Total

217

218

3 (1.4)5 (2.3)

Abdominal aorta
Periphearal artery

66
3066
30

0
1 (3.3)01 (3.3)

Operations

250
200

Car+Thorac.
Thoracic
Cardiac150
100
5001999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Ⅱ. Mode of Operation
total

Scheduled (%)

Urgent (%)

Emergent (%)

Ischemic
ValvularCongenital
Otherso ac c aorta
ao ta
Thoracic
Abdominal aorta
Peripheral artery

549761249966
30

45 (83.3)
90 (92.8)
6 (100)6 (50.0)26
6 (53.
(53.1))
57 (86.4)
10 (33.3)

5 (9.3)6 (6.2)03 (50.0)4 (8.
(8.1))
004 (7.4)
1 (1.0)03 (50.0)
199 (38.8)
9 (13.6)
20 (66.7)

Total

314

240 (76.4%)

18 (5.7%)

56 (17.9%)

Ⅲ. Age Distribution
ThoracicIschemic
Valve

80

2460

1140

18

20
0

3
13-49

53
16

31

50-59

60-69

2540

128670-7980-

～Summary of Cardio-Vascular Division～

Ⅰ. Number of Operations and Surgical Mortality
No. Cases

No. OP.

OP. mortality (%)

Hosp. mortality(%)

102(9)
77(2)612103

1 (1.0)1 (1.0)77

1 (1.3)

1 (1.3)612000054(4)(20)
66(27)
30

54

2 (3.7)4 (7.4)

66

00

30

1 (3(3.3)
3)

1 (3(3.3)
3)

C diCardiac
Valvular(redo)
Ischemic(redo)
Congenital
Others
VascularThoracic aorta(redo)(Stent graft)
Abdominal aorta(Stent graft)
Peripheral artery

Concomitant Procedure
Valvular(only): 72 cases
CABG(only): 54 cases
Thoracic aorta(only): 43 cases
Valvular + CABG: 19 cases
Valvular + Thoracic aorta: 7 cases
Valvular + Congenital: 2 cases
Valvular + Others: 2 cases
CABG + Thoracic aorta: 3 cases
V l l + CABG + Th
ValvularThoracic
i aorta:t : 1 caseⅡ. Valvular Heart Disease
No. Cases

No. OPOP mortality （%)

Hosp. mortality (%)

Aortic *Mitral
Tricuspid
Pulmonary

4629
4046
30
4000000000

Combined
Cbi dA+M
M+T
A+M+T

11111

11111

1 (9.1)001 (9.1)
00Total102103

1 (1.0)1 (1.0)* Bentall ope 3casesa)) M-repair
MiDiagnosis
MRMSr

MsRMSMSR

Total

MVR (%)

Repair (%)

3700003716 (33.3%)

32 (66.7%)

Etiology
Congenital

Infectious

Degenerative

Ischemic

DCM

232732

Post ope. follow up
Jet area

No. Ope

Post ope. (discharge)

Follow((～12M))non to trivial(0-2cm2)

3732

31

mild
(2-4cm2)

03

4

mild to moderate(4-8cm2)

010moderate to severe(8cm2- )001b) Valve Substitutes implanted
p79 Prostheses

MechanicalTissueTotal

AVRMVRTVR
PVR1912004044059
1640Total

314879

Ⅲ. Ischemic Heart Disease

Total

Isolated CABG

OP. mortality(%)

Hosp. mortality(%)

SVD
DVD
TVD
LMT

12103421462618000
1 (5.0)000
1 (5.0)

Total

77

54

1 (1.4)( )

1 (1.4)( )Off pump CABG : 15 casesa) Conduit

On pump beating CABG : 3 cases

191 ( 2.5 / patient )Artery

SVG

Cases

SVD
DVD
TVD
LMT

101049322115126

1543424

Total

101 (52.8%)

90 (47.2%)77b) Anastomoses

202 ( 2.6 patient )b’) Anastomoses by OPCAB
31 ( 2.1 / patient )No. Anastomoses

No. Cases (%)

No. Anastomoses

No. Cases (%)

123456121934
10201234546500

Total

77

Total

15Total anast.

202

Total anast.

31c) Anastomoses

No.
Anastomos
es12345No. OP

SVDDVDTVD
LMT

12000067604
18
1200
8
2001112103421Total

121934

10277

Total anast.

12381024010202c) Graft patency

Anastomoses

Examined

PatentRate**Stenosis*Rate***

SVG

100

74

70

94.60100

Artery102

838197.6

196.4

LITA
RITA
GEA

7130
15626
155
25
198.2
96.2
1000
1098.2
92.3
100

Total

202

157(77.7%)

15296.8 (%)

196.2 (%)

Intervention : 3 case

*Stenosis : ≧90%**patency rate (excl.stenosis)*** patency rate (incl.stenosis)

Ⅳ. Congenital Heart Disease
No. Cases

No. OP.

OP. mortality (%)

Hosp. mortality
(%)

122
1

122
1000000006600No.
Cases

No. OP.

OP. mortality (%)

Hosp. mortality(%)

Cardiac
Cdi tumor
Constrictive pericarditis
VSP/LV aneurysm
DCM VAS implantation
BleedingOthers

422112422112000000000000

Total

121200No. Cases

Sinus recovery(%)

Cryoablation

12866.7%

Total

12866.7%

ASD
VSD
PDA
VSA(Valsalva)
Total

Ⅴ. Others

Ⅵ. Maze operation

Ⅶ. Vascular Diseasea) Replacement site
No. Cases

No. OP.

OP. mortality (%)

Hosp. mortality(%)

Thoracic
Ascending aorta
Hemiarch
Total arch
Descending aorta(Stent graft)Thoracoabdominal Ao.

3131323(20)23131323(20)20
1 (7.7)000
1 (50)0
1 (7.7)0
1 (4.4)1 (5.0)1 (50)

Total

54

54

2 (3.7)4 (7.4)

No. Cases

No. OP.

OP. mortality (%)

Hosp. mortality(%)

Abdominal aorta(Stent graft)
Peripheral artery

66(27)
3066(27)30

00
1 (3(3.3)
3)00
1 (3(3.3)
3)

Total

96

96

1 (1.0)1 (1.0)b) Classification of Thoracic aorta
No.
Cases

Hosp. mortality (%)ⅠⅡⅢaⅢb20149212

1 (5.0)1 (7.1)1 (11.1)000Ⅰ
ⅡⅢaⅢb6020400002(50 0)2(50.0)343
13171000
1 (5.9)0Dissecting
Acute

ChronicTrue
AscendingArch
DescendingThoracoabdominal

Operation method

Total arch replacement
Hemiarch replacement (+CABG)
Stent Graft

293

Hemiarch replacement (+AVR)
Descending aorta replacement
Thoracoabdominal Ao. replace.
Stent graft

2
112

Total arch replacement(+CABG)
Total arch replacement(+Bentall/AVR)
BentallHemiarch replacement(+AVR)
Descending aorta replacement
Stent graftThoracoabdominal Ao. replace.

74322151c) Classification of Abdominal aorta, peripheral artery
No.
Cases

Hosp. mortality(%)

Abdominal aorta
AAA
Non-ruptured
Ruptured

66
66
57
90000

Graft replacement
Stent Graft3927

Peripheral artery
ASO
Acute arterial occlusion
Aneurysm
Traumatic
Others3010122
421 (3.3)
01 (8.3)000

Thrombectomy
B
BypassgraftingftiPlasty
Others15933

Operation method

～ Summary of Hospital death ～

No.

氏名性年
齢診断

手術日

緊/待術後日数

術式

死亡日

剖検

死因

U-AP OMI HD AS MR

2010/1/21

緊

19

CABG ｘ 2 AVR MP

2010/2/9

無MOF

弓部全置換術後仮性動脈瘤

2010/5/15

緊急75

TEVAR(stent graft)

2010/8/1

無食道廔

AD(A) CD(B) DIC

2010/11/16

緊急

1

部分弓部置換術

2010/11/17

無出血

CD(B) DIC TEVAR後

2010/4/22

待機

1

弓部全置換術 CABG

2010/4/23

無出血

CD(B)

2010/8/26

待機56

遠位弓部胸部下行全置換術

2010/10/20

無NOMI・MOF

AAO HD MNMS

2010/6/3

緊1

血栓除去

2010/6/4

無MNMS

Cardiac 1 case
1○下 ○子F75

Thoracic aorta 4 cases

1233○代 ○雄○岡 ○子○道 ○紀○藤 ○則M

FFM83784758

Peripheral artery 1 cases

1○口 ○喜M67各種データの解釈1)) OP mortality:l
術後 日以内 全死亡
術後３０日以内の全死亡。
Hospital mortality: 術後院内での全死亡。（他科転科後の他病死も含む。 他院転院後の手術関連死も含む）
2) Mode of Operation: 二つ以上のカテゴリーを含む手術は主病変と考えられるいずれかのカテゴリーに分類。ただし、CABG＋弁/大血管手術はそれぞれ弁、大血管手術としてカウント。Bentall手術は大血管手術としてカウント。
3) Number of Operations and Surgical Mortality: 各手術手技の延べ数を合算。
例：CABG + MP + As.Ao.置換→Ischemic, Valvular, Thoracic aortaのそれぞれに加算。
Bentall OP→Valvular, Thoracic aortaのそれぞれに加算。
4) Valvular Heart Disease: 弁に対する操作を行った（付加手術の有無にかかわらず）症例数、手術数を計算。
5) Ischemic Heart Disease: CABGを行った（付加手術の有無にかかわらず）症例数を計算。
6) Vascular Disease: Ascending aortaに対する手術はBentall OPを含む。