Performance Report

In 2023, IJN surgeons performed a total of 4,476 cardiothoracic surgeries including:

• Coronary Artery Bypass Grafting (CABG)
• Congenital Heart Surgery
• Heart valve repair and replacement

In 2023, IJN surgeons performed 2,939 open heart surgeries and 1,268 closed heart surgeries:

• Open Heart: CABG, Congenital Heart surgery, Heart valve repair and replacement, Aortic root surgery
• Closed Heart: Thoracic surgery, Vascular surgery, Patent Ductus Arteriosus (PDA) ligation, Blalock Taussig (BT) Shunt, Coarctation repair

Total Number of Cardiothoracic Surgeries

Patients with a complex medical background present greater challenges for cardiac surgery. Almost half the patients had diabetes mellitus at time of surgery, and more than two thirds had hypertension and hypercholesterolemia.

In 2023, patients who have had cardiac surgeries had more complex backgrounds than patients at comparable hospitals as evidenced by higher EuroSCORE – Parsonnet average risk scores.

All operations

The survival rate for all open-heart surgery was 95.8% in 2023, which is better than the predicted survival rate estimated by the EuroSCORE and Parsonnet scoring system.

Isolated Coronary Artery Bypass Grafting (CABG)

The survival rate for isolated CABG surgery was 96.8% in 2023, which is better than the predicted survival rate estimated by the EuroSCORE and Parsonnet scoring system.

Mitral Valve Repair is preferred over valve replacement whenever suitable. We report that there was no death (mortality) for patients undergoing mitral valve repair from 2021 to 2023.

VSD Closure is the commonest surgery for acyanotic congenital heart defects. The death (mortality) rate for simple VSD closure is 0.8% in 2023.

Total Number of Procedure:

*VSD closure – RACHS-1 SCORE 2

TOF correction is the most common surgery performed for cyanotic congenital heart defects. The death (mortality) rate for simple TOF correction is 1.3% in 2023.

Total Number of Procedure:

One of the key performance measures is the use of appropriate medications before and after PCI.

From year 2021 to 2023, IJN achieved 98% use for all medication categories, which is comparable with ACC-National Cardiovascular Data Registry (NCDR).

*Source of data: Cardiology Quality Indicators database

The rate of in-hospital mortality among patients who had PCI procedures at IJN in 2023 is lower compared with ACC- National Cardiovascular Data Registry (NCDR).

IJN continues to improve door-to-balloon time to reduce the risk of mortality and morbidity, well below the target of 90 minutes for emergency treatment of Acute Myocardial Infarction or heart attacks. (American College of Cardiology/American Heart Association (ACC/AHA) guidelines for PCI inflation).

IJN median door-to-balloon time was 52 minutes in 2023.

In 2023, IJN performed more cardiac catheterization procedures using radial access than other comparable hospitals
(n= 7,070).

The use of radial access is associated with reduction in bleeding complications, readmission rates, infection, and recovery time compared with PCI procedures done using a femoral approach.

A total of 860 patients had transcatheter (non-surgical) procedures at IJN in 2023.

In 2023, IJN performed 409 interventional procedures for paediatric and adult congenital heart disease patients. The top 6 interventional procedures are; ASD Occlusion, PDA Occlusion, PDA Stenting, Percutaneous Transluminal Balloon Valvuloplasty (PTBV), VSD Occlusion, and Right Ventricular Outflow Tract (RVOT) Stenting.

Note: Numbers show by cases (count by Cath No.), e.g.: Patient undergone for Cardiac Cath and ASD occlusion, case count in “Intervention” group

In 2023, IJN surgeons performed 1,105 paediatric cardiac surgeries.

*(Open Heart=949 & Close Heart= 156)

VSD  : Ventricular Septal Defect

TOF  : Tetralogy of Fallot

ASD  : Atrial Septal Defect

AVSD: Atrioventricular Septal Defect

Closed Heart:

• Patent Ductus Arteriosus (PDA) Ligation
• Blalock Taussig (BT) Shunt
• Coarctation of the Aorta (CoA) Repair
• Pulmonary Artery (PA) Banding
• Permanent Pacemaker (PPM) Implantation

The hospital length of stay for ASD, TOF and VSD were divided into 3 categories:

1. Pre-op stay
2. ICU stay
3. Post-op stay

**ASD: Atrial Septal Defect

TOF: Tetralogy of Fallot

VSD: Ventricular Septal Defect

**Mainly complex and/or very young patients which were not suitable for transcatheter device closure