Changes in the congenital heart disease spectrum at China national children's medical center: a review of 10-year data.

Background: With the decline in the birth rate and simultaneous advancements in medical technology in China, research on how birth population changes have affected congenital heart disease (CHD) surgery in the last 10 years has increased. Method: We investigated the medical data of all patients diagnosed with CHD treated at the surgical department at our hospital from January 2013 to December 2022, including their age and the type of surgery. We classified patients into two groups based on their age: less than 1 year (younger) and greater than 1 year (older). We defined patent ductus arteriosus, atrial septal defect, and ventricular septal defect as simple CHDs and others as complex diseases. Vascular ring diseases, including double aortic arch, pulmonary artery sling, and aberrant left subclavian artery with diverticulum, were considered special conditions. Result: We found that 6440 patients underwent surgery at our hospital in the period mentioned. The number of surgeries conducted annually increased significantly from 609 in 2016 to 941 in 2019 but gradually declined since 2020. The proportion of simple CHD cases increased annually, whereas the proportion of complex CHD cases declined. The proportion of patients with vascular ring disease gradually increased. The proportion of older children increased, whereas that of younger children decreased each year. All changes were statistically significant. Conclusions: Owing to advancements in medical technology, economic factors, change of birth rate and abortion rate, the number of surgeries for CHDs has decreased significantly. It is challenging to predict future trends. Nevertheless, this phenomenon is specific to China. Policymakers, hospitals, and surgeons must introduce appropriate adjustments in response to this change.