The Observation for the Dead Children with Congenital Heart Disease

Park, Dong Chul; Sul, Jun Hee; Lee, Sung Kyu; Chin, Dong Shik

Abstract

In the treatment of congenital heart in Korea, a big progress has made so far, and successful results have been achieved. However, there were few reports pertaining to the age and cause of death in congenital heart disease patients. Now, the author made observation on the mortality, the age and the mode of death in 3817 patients of congenital heart disease who had been admitted to Severance Hospital during the period of 15 years, from Jan 1972 to Dec 1986. The overall hospital mortality of the congenital heart disease was 6.1% ; 10.1% in the unoperated cases and 4.5% in the patients who underwent surgery. The hospital mortality of indivisual congenital heart disease was, in the order of increasing frequency, 1.0% for ventricular septal defect, and for the complicated heart disease, such as transposition of great vessels(12.5%), and total anomalous pulmonary venous return(15.8%) the death rate was higher in general. The mortality was highest under 1 year of age, especially during the neonatal period, i.e. under 1 month of age. The mode of death in the unoperated cases were congestive heart failure, infection, and hypoxia, in the order of frequency, comprising 84.5%, and in the patients who underwent surgery were congestive heart faliure or low cardiac output syndrome and htpoxia, 62.3%. Among the patients who died in the neonatal period, 76.9% died without accurate diagnosis, and 38.5% were under 5 days of age. Hypoxia(27%), congestive heart faliure(19.4%), and sepsis(11.6%) were the main mode of death. The analysis of the dead patients with congenital heart disease revealed the following results.The mortality was high in the complicated heart disease ; the major mode of death in surgical patients were congestive heart faliure or low cardiac output syndrome ; and the mortality was high in patients under one year of age, especially in the neonates, and most of then lacked accurate diagnosis.Therefore, more accurate properative diagnosis of complicated heart disease and better surgical techniques, development of diagnostic tools in neonatal period, and the need for early surgery and emergency medical management are uregently demanded.