Trends and outcomes in neonatal cardiac surgery for congenital heart disease in Japan from 1996 to 2010.

OBJECTIVES: Clinical outcomes for neonatal cardiac surgery have improved dramatically over the last decade in Japan; however, few nationwide surveys have been reported in this field. The aim of this study was to investigate the current trends and outcomes of neonatal cardiac surgery in Japan over a period of 15 years.

METHODS: All data were derived from the official annual reports by the Japanese Association for Thoracic Surgery (JATS) between 1996 and 2010. Data collected included patient age (neonates, 0-30 days), cardiac diagnosis, operative procedure with or without cardiopulmonary bypass (CPB or non-CPB) and hospital death.

RESULTS: The number of neonatal cardiac surgeries annually in children during the study period significantly increased from 791 cases (9.4%) in 1996 to 1585 cases (16.6%) in 2010. The major diagnoses were simple transposition of the great arteries (TGA) (20.0%) and total anomalous pulmonary venous return (19.2%) in the CPB group, and patent ductus arteriosus (35.5%) in the non-CPB group. The annual number of cardiac surgeries for hypoplastic left heart syndrome gradually increased during the study period, and it has been increasingly performed in neonates with preponderance, since 2007, of non-CPB procedures over the Norwood procedure with CPB since 2007. The hospital mortality of neonatal cardiac surgery has dramatically decreased from 21.2% to 6.9% (P < 0.0001), and especially in neonates with hypoplastic left heart syndrome from 75.4% in 1996 to 17.6% in 2010.

CONCLUSIONS: Current neonatal cardiac surgery trends during the past decade were clearly identified, and hospital mortality in Japan was comparable with that of recent reports from other national databases.