Heart Center

Heart Center The Heart Center of the Women and Children’s Medical Center Affiliated with Guangzhou Medical University comprises several related departments and disciplines, including cardiovascular surgery, cardiac intensive care (CICU), pediatric cardiology, extracorporeal circulation and respiratory-circulatory support, cardiac ultrasonography, and a specialized outpatient clinic for congenital heart disease. It has established an integrated multidisciplinary diagnosis and treatment system, thereby creating a “green fast track” for the diagnosis and treatment of patients with heart disease.

The Heart Center currently has 56 open ward beds, 25 cardiac intensive care beds, and 2 dedicated cardiac operating rooms, equipped with a variety of advanced instruments and equipment to meet surgical needs. Each year, it routinely admits more than 1,500 cases of various complex congenital cardiac malformations from South China and 22 provinces and municipalities throughout the country, as well as critically ill and difficult cases. The Heart Center currently has 6 chief physicians, 13 deputy chief physicians, 10 attending physicians, and 15 resident physicians, including 16 doctoral students and 24 master’s students.

Over the past ten years, the Department of Cardiovascular Surgery has routinely performed more than 1,000 cardiac operations of various types each year. The number and difficulty of operations have consistently ranked among the top three in the national children’s hospital system, with a surgical success rate of over 98%. It can routinely provide comprehensive treatment for neonates and patients with low body weight or critical complex congenital heart disease. It has particular expertise in the surgical treatment of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCAs); the number of surgical treatments for this condition ranks first in the country, and the surgical treatment success rate has reached an internationally advanced level. In addition, our center has begun performing tracheoplasty and has successively completed a series of procedures, including tracheal suspension, slide tracheoplasty for O-shaped tracheal ring stenosis, and external stenting for tracheomalacia. At present, the volume and quality of surgery consistently rank among the leading levels in the country, and the center was also among the earliest in China to perform secondary interventions after failed tracheoplasty. Thoracoscopic surgery and da Vinci robot-assisted thoracoscopic surgery are also actively carried out, providing patients with more treatment options.

At present, the Department of Cardiovascular Surgery has established an integrated diagnosis and treatment system consisting of prenatal diagnosis and counseling – cardiovascular specialty and congenital heart disease outpatient clinic – cardiovascular ward – cardiac imaging diagnosis – surgery – postoperative intensive care – post-discharge follow-up. The comprehensive treatment of pulmonary atresia/ventricular septal defect/major aortopulmonary collateral arteries and the application of tracheoplasty in congenital tracheal stenosis and tracheomalacia have been designated major clinical technology projects in Guangzhou.

In recent years, the Cardiac Intensive Care Unit has rapidly improved its postoperative management techniques for complex congenital heart disease. It has also accumulated extensive experience in the rescue and treatment of critical conditions caused by nonsurgical diseases, such as fulminant myocarditis, cardiogenic shock and multiple organ failure caused by various factors; in the rescue and treatment of pulmonary hypertension crises caused by idiopathic pulmonary arterial hypertension and persistent pulmonary hypertension of the newborn; and in the support and treatment of multiple organ failure. It has mature management experience for children with complex airways, such as those who undergo tracheoplasty for congenital tracheal stenosis. It was the first intensive care unit in China to focus on perioperative critical care nutrition, formulate nutrition management strategies, and conduct multiple studies on the perioperative and mid- to long-term postoperative nutritional status of children with congenital heart disease. The unit routinely performs electronic bronchoscopy and continues to develop new technologies and projects, such as Most-Care minimally invasive hemodynamic monitoring and the application of cerebral oxygen saturation and electroencephalography in children after congenital heart surgery. As a principal member of the hospital’s ECMO collaboration group, the unit guides other departments in achieving good outcomes for children with noncardiac diseases. It has also developed pediatric cardiopulmonary exercise testing, filling a gap in China. In 2023, it was designated as a construction unit for a National Standardized Cardiac Rehabilitation Center and a National Standardized Pulmonary Vascular Disease Demonstration Center.

The Department of Pediatric Cardiology was established in the 1980s and was one of the earlier pediatric tertiary disciplines in China. After more than 30 years of discipline development, the Department of Cardiology has developed into a well-known domestic pediatric heart disease diagnosis and treatment center integrating medical care, education, and research. It has also accumulated extensive experience in the diagnosis and treatment of various cardiovascular diseases in children, including congenital heart disease, Kawasaki disease, arrhythmia, myocarditis, heart failure, and cardiomyopathy. Since the 1990s, our hospital was among the first in China to perform pediatric atrial septostomy and cardiac catheterization examinations. In 1999, it began interventional treatment of congenital heart disease. In addition to routinely performing cardiac catheterization and cardiovascular angiography for complex congenital heart malformations, current interventional treatments for congenital heart disease include not only interventions for common congenital heart diseases, but also pulmonary artery stent implantation, occlusion of major aortopulmonary collateral arteries associated with pulmonary sequestration, and interventional treatment of coronary artery fistulas and pulmonary arteriovenous fistulas, among various other procedures. Approximately 400 cardiovascular interventional diagnostic and therapeutic procedures are performed each year, with an overall technical success rate of more than 99%. Nearly 5,000 cases have been cured cumulatively, with few complications. More than 1,200 children with cardiovascular diseases are admitted each year.

The extracorporeal circulation group is committed to extracorporeal circulation management for surgery on infants and young children with complex congenital heart disease and ECMO operation management for critically ill children in our hospital. It actively optimizes tubing miniaturization and microsizing and carries out small-volume priming and bloodless priming techniques. More than 50 ECMO cases are completed each year, ranking among the leading pediatric hospitals nationwide.

Introduction to special technologies 1. Surgical treatment of neonatal, low-body-weight, critically ill, and complex congenital heart disease: High-difficulty and complex pediatric cardiac surgical procedures are widely performed, including the double-switch operation, Senning, Rastelli, Cone, DKS, Ross/Konno, Ross II, modified Nikaidoh, Norwood operations, and pulmonary artery unifocalization. 2. Comprehensive treatment of pulmonary atresia/ventricular septal defect/major aortopulmonary collateral arteries: Over the past 10 years, staged or one-stage corrective surgery has been completed for more than 500 patients with pulmonary atresia combined with ventricular septal defect. The center has particular expertise in the surgical treatment of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCAs, namely types B/C). Professor Chen Xinxin, the project leader, pioneered the surgical treatment of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCAs) in China in 2003. To date, staged or one-stage corrective surgery has been performed for more than 190 patients with this complex malformation. The complete repair rate can reach 60%, placing the number and outcomes of surgical treatments for this condition first in the country, with a surgical treatment success rate reaching an internationally advanced level. For three consecutive years, Master Classes and Advanced Training Classes have been held in China to promote surgical treatment strategies for this complex malformation, attracting children from more than 20 provinces and municipalities nationwide for treatment. 3. Minimally invasive surgery for congenital heart disease: Minimally invasive procedures are widely performed, including median and axillary mini- or small-incision surgery and thoracoscopic surgery. 4. Extracorporeal membrane oxygenation (ECMO) technology for treating cardiopulmonary failure caused by various diseases: Since ECMO support was first applied in 2010 to children with low cardiac output after surgery for complex congenital heart disease, a hospital-wide ECMO collaboration group has been established under the leadership of the Heart Center, enabling ECMO technology to be widely promoted in all ICUs throughout the hospital. Over the past 3 years, the number of ECMO cases throughout the hospital has increased dramatically. The supported diseases have expanded from being limited to low cardiac output after cardiac surgery and fulminant myocarditis to including various types of severe pneumonia, congenital diaphragmatic hernia, persistent pulmonary hypertension of the newborn, and others. 5. Cardiopulmonary exercise testing (CPET) in children: Since our department officially began performing CPET in December 2018, examinations have been completed for nearly 1,600 subjects in total, including approximately 1,200 patients after congenital heart surgery. These included follow-up of patients after various complex congenital heart operations, as well as patients with arrhythmia and Kawasaki disease. More than 100 healthy children also participated in the examinations. Testing not only guides exercise rehabilitation for patients with heart disease, but also provides substantial reference value for the differential diagnosis of symptoms such as chest pain and chest tightness. 6. Comprehensive evaluation and diagnosis and treatment of Kawasaki disease: Kawasaki disease is one of the main diseases treated in the pediatric cardiology outpatient and inpatient departments. More than 600 patients are admitted each year, including many complex and referred cases. After years of effort, the Department of Pediatric Cardiology has established a systematic evaluation, diagnosis, and treatment system for Kawasaki disease and has conducted a series of basic and clinical studies. It has accumulated extensive experience in the diagnosis and treatment of incomplete Kawasaki disease, intravenous immunoglobulin-unresponsive Kawasaki disease, and severe complications of Kawasaki disease, such as giant coronary artery aneurysm and Kawasaki disease shock syndrome, reaching a leading level in the province and an advanced level nationally.