Annual Report of Cardiovascular Surgery 2011

Nagasaki University
2011.1～2011.12

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

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

No.
Cases

No. OP.

OP. mortality (%)

Hosp. mortality (%)

CardiacThoracic

1655816658

2 (1.2)5 (8.6)4 (2.4)5 (8.6)

Car. + Thoracic

5500

Total

2282297 (3.0)9 (3.9)Abdominal aorta
Periphearal artery

5840584000

1 (1.7)0Operations

250
200

Car+Thorac.
Thoracic
Cardiac

150
100
500

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Ⅱ. Mode of Operation
total

Scheduled (%)

Urgent (%)

Emergent (%)

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

41101
91563584232 (78.0)
94 (93.1)
9 (100)7 (46.7)
34 (53(54.0).0)
53 (91.3)
16 (38.1)

5 (12.2)
5 (5.0)02 (13.3)
5 (7.9)02 (4.8)4 (9.8)2 (1.9)06 (40.0)
24 (38.
(38.1))
5 (8.7)24 (57.1)

Total

329

245 (74.5%)

19 (5.8%)

65 (19.7%)

Ⅲ. Age Distribution
ThoracicI h iIschemic
Valve

80

2760
131040200327661127-49

50-59

60-69

1739

24
6
1770-7980-

～Summary of Cardio-Vascular Division～

Ⅰ. Number of Operations and Surgical Mortality
No. Cases

No. OP.

OP. mortality (%)

Hosp. mortality(%)

107(11)
62
11
16108

1 (1.0)3 (2.8)621116

1 (1.6)00

1 (1.6)
1 (10.0)063(10)(19)
58(20)
42

63

5 (7.9)5 (7.9)580

1 (1.7)4200

C diCardiac
Valvular(redo)
Ischemic
Congenital
OthersV
Vascularl
Thoracic aorta(redo)(Stent graft)
Abdominal aorta(Stent graft)
Peripheral artery

Concomitant Procedure
Valvular(only): 81 cases
CABG(only): 41 cases
Congenital(only): 9 cases
Others : 15 cases
Thoracic aorta(only): 58 cases
Valvular + CABG: 17 cases
Valvular + Thoracic aorta: 3 cases
Valvular + Congenital: 5 cases
V l l + Others:
ValvularOth : 1 cases
CABG + Thoracic aorta: 2 cases
Valvular + CABG + Congenital: 1 caseⅡ. Valvular Heart Disease
No. Cases

No. OPOP mortality （%)

Hosp. mortality (%)

Aortic *Mitral
Tricuspid
Pulmonary

50
37
3150
38
3
100
1 (33.3)
01 (2.0)01 (33.3)
1 (100)Combined
Cbi dA+M
A+T
M+T
A+M+T

4282428200000000Total

1071081 (0.9)3 (2.7)* Bentall
Bll ope 2 casesa) Mitral valve disease
Diagnosis
MRMSrMsRMSMSRTotal

MVR (%)

Repair (%)

44004351

11 (21.6%)

40 (78.4%)b) Mitral valve repair
Etiology
Congenital

Infectious

Degenerative

Dilation

Ischemic

DCM

1228

5

3

1

Post ope. follow up
Jet area

No. Ope

Post ope. (discharge)

Follow((～12M))non to trivial(0-2cm2)

4035

23

mild(2-4cm2)046

mild to moderate(4-8cm2)

002

moderate to severe(8cm2- )010c) Valve Substitutes implanted
p74 Prostheses

MechanicalTissueTotal

AVRMVR
TVR
PVR

247103443158
1141Total

32 (43.2%)

42 (56.8%)74d) 右小開胸下心臓手術 (MICS)
ProcedureCase

MP14MVR

2ASD

1LA Myxoma

1Ⅲ. Ischemic Heart Disease

Total

Isolated CABG

OP. mortality(%)

Hosp. mortality(%)

SVD
DVD
TVD
LMT

91224
172
6
17
1600
1 (4.2)000
1 (4.2)0Total6241

1 (1.6)( )1 (1.6)( )Off pump CABG : 7 casesa) Conduit

On pump beating CABG : 13 cases150 ( 2.4 / patient )ArterySVG

Cases

SVDDVD
TVD
LMT

510382441135239122417Total

77 (51.3%)

73 (48.7%)62b) Anastomoses

160 ( 2.6 patient )b’) Anastomoses by OPCAB
12 ( 1.7 / patient )No. Anastomoses

No. Cases (%)

No. Anastomoses

No. Cases

123456131324
11
10

1234
53 (3)
3 (10)
1 (7)
00

Total

62Total

7 (20)

Total anast.

160

Total anast.

12 (44)c) Anastomoses

No.
Anastomos
es12345No. OP

SVDDVDTVD
LMT9310092200
1410006500109122417Total

13132411162

Total anast.

132672445160d) Graft patency

Anastomoses

Examined

PatentRate**

Stenosis*Rate***

SVG

83

46

4495.6

193.5

Artery77383797.4

097.4

LITA
RITA
GEA

5222326111

2511196.2
100
100

00096.2100100Total

16084 (52.5%)

8196.4 (%)

196.2 (%)

Intervention : 2 case

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

Ⅳ. Congenital Heart Disease
No. Cases

No. OP.

OP. mortality (%)

Hosp. mortality(%)

621116111
1000000
1 (100)
00

11110

1No.
Cases

No. OP.

OP. mortality (%)

Hosp. mortality(%)

CardiacC
di tumor
Constrictive pericarditis
LV aneurysm/rupture
VAS implantation
Pulmonary embolism
LA thrombus
Others

522
1
123

522
1
12
3

00000000000000T t lTotal

161600No. Cases

Sinus recovery(%)

11666.7%

ASDVSD
TOF(conduit)
PDA
VSA(Valsalva)
Total

Ⅴ. Others

Ⅵ. Maze operation

Cryoablation

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.

416
1424(19)54
161424(19)50
2 (12.5)
1 (7.1)1 (4.2)(1)
1 (20.0)02 (12.5)
1 (7.1)1 (4.2)(1)
1 (20.0)

Total

63

63

5 (7.9)5 (7.9)No. Cases

No. OP.

OP. mortality (%)

Hosp. mortality(%)

Abdominal aorta(Stent graft)
Peripheral artery

58(20)
4258(20)420001 (17.2)(1)
0Total100

10001 (1.0)

b) Classification of Thoracic aorta
No.
Cases

Hosp. mortality (%)ⅠⅡⅢaⅢb2720
142
133 (11.1)
3 (15.0)
2 (14.3)00
1 (33.3)

Total arch replacement
Hemiarch replacement (+CABG)
Descending aorta replacement
Stent Graft21413ⅠⅡⅢaⅢb7221200000

Total arch replacement
Hemiarch replacement
Ascending aorta replacment
Descending aorta replacement
Stent graft

311113631018
52 (5.5)
01 (10.0)01 (20.0)

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

92
1
3
15
5

Dissecting
Acute

Chronic

True/False
AscendingArch
DescendingThoracoabdominal

Operation methodc) Classification of Abdominal aorta, peripheral artery
No.
Cases

Hosp. mortality(%)

Abdominal aorta
AAA
Non-ruptured
RupturedASO

585651521 (1.7)
1 (1.8)1 (2.0)00

Graft replacement
Stent Graft
Aorto-bifemoral bypass

26202

Peripheral artery
ASO
Acute arterial occlusion
Aneurysm
TraumaticOthers

421811571000000

Thrombectomy
B
Bypass(FP/FF/(FP/FF/others)th )PlastyGraft replacment
Others1118
751

Operation method