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Congenital Heart Disease

Congenital Heart Disease. At Birth : 6~10 / 1,000 live birth Natural Survivor at puberty (Presurgical era) : 5 ~ 15 % Natural & Unnatural Adult Survivor (Surgical era) : over 85 %. ‘Congenital Heart Disease’ Korean experience during past 50 Years. Heung Jae Lee.

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Congenital Heart Disease

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  1. Congenital Heart Disease At Birth : 6~10 / 1,000 live birth Natural Survivor at puberty (Presurgical era) : 5 ~ 15 % Natural & Unnatural Adult Survivor (Surgical era) : over 85 %

  2. ‘Congenital Heart Disease’Korean experience during past 50 Years Heung Jae Lee Professor of Pediatrics, Sungkyunkwan University School of Medicine Samsung Medical Center, Seoul, Korea

  3. Surgical Landmarks in Korea 1953, Pulmonary stenosis 1957, TOF shunt 1958, PDA ligation 1959, Open heart surgery (VSD) 1978, Fontan op 1985, Arterial switch op for TGABalloon valvuloplasy for Valvar PS

  4. Open Heart Surgery in Korea August 6th 1959 OHS for 8yr-old girl with VSD under cardiopulmonary bypass !! YK Lee, CY Hong et al First trial in Korea

  5. Cardiac Surgery for CHD in Korea GNP 10000 10000$ The Korean Heart Foundation 5000$ 5000 National Social Security System The overseacharity operation 4000 First Open Heart Surgery 3000 2000$ 2000 1000 1000$ * * 100$ 0 [Year] [US $] r Korean War

  6. Early & mid 1970th in Korea Mrs. Hodges save over 3,300 Korean kids with CHD in 1970th

  7. Early 1980th in Korea ‘KHF-Pediatric Heart Fellowship’ program Support Over 20,000 Kids during last 25 years Mrs. Lee Soon Ja

  8. Congenital Heart in Korea .... Where are we now ??

  9. Congenital Heart Op (SMC 2001) n = 428

  10. Intervention Vs OP in PDA (Excluding NICU cases)

  11. Percentile Profile of Current Management of CHD in Korea : 1992-2000

  12. Cardiac surgery without Catheterization Catheterization required when complete segmental analysis is not possible. • VSD • ASD • TOF • Neonatal PDA • CoA/ IAA • TAPVR, Truncus Arteriosus • Critical AS in newborn • Shunt op. in newborn • Congenital Valvular Heart Ds (MR etc)‏ • TGA with IVS

  13. Impact of fetal diagnosis of congenital heart disease in Korea

  14. Outcome of fetal Diagnosis (2000~2001) TOP*: termination of Pregnancy FDIU ** : Fetal death Intra Uterine

  15. ‘ Fetal Echo Effect’ in Korea • Rate of termination of pregnancy (TOP) 33.2% in ’98-’99 period, 35.8% in ’00-’01 periodAssociated with early diagnosis and associated extracardiac malformations including chromosomal anomaly • Perinatal mortality & morbidity of the CHDs which requires neonatal cardiac procedure is improving through the planned delivery at the cardiac center - 100% survival of arterial switch operation in cases with TGA with IVS in ’98-’99 period( 5 cases ) - The improved result of neonatal balloon angioplasty in cases with critical PS and PA IVS

  16. We are now in the Era of…… • Neonatal/Infant Cardiac Surgery • Dx. Era of Echocardiography & MRI • Catheter Intervention • Fetal & Perinatal Cardiology • Grown Up Congenital Heart (GUCH)‏ • Molecular-genetic Approach, CATCH 22 etc.

  17. Cardiac Surgery for CHD in Korea GNP 10000 10000$ The Korean Heart Foundation 5000$ 5000 National Social Security System The overseacharity operation 4000 First Open Heart Surgery 3000 2000$ 2000 1000 1000$ * * 100$ 0 [Year] [US $] r Korean War

  18. Two major factors for the success Heart to Heart Project; With Vietnamese Kids & Doctors at SMC 1) Rapid economic development & Active social supporting systems (such as social security system and philanthropic organizations) 2) Overseas training for medical experts and their commitment.

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