Children’s Heart Center

Children’s Cardiac Center

The Cardiac Center of the Women and Children’s Medical Center Affiliated to Guangzhou Medical University comprises cardiovascular surgery, the Cardiac Intensive Care Unit (CICU), pediatric cardiology, extracorporeal circulation and respiratory and circulatory support, cardiac ultrasonography, a congenital heart disease specialty outpatient clinic, and multiple other related disciplines and departments. It has established an integrated multidisciplinary diagnosis and treatment system, thereby creating a “green fast track” for the diagnosis and treatment of cardiac patients. The Cardiac Center currently has 56 available ward beds, 25 cardiac intensive care beds, and 2 dedicated cardiac operating rooms, equipped with various advanced instruments and devices to meet surgical needs. Every year, it routinely admits more than 1,500 cases of various complex congenital cardiac malformations, as well as critically ill and difficult cases, from South China and 22 provinces and cities throughout the country. The Cardiac Center currently has 6 chief physicians, 13 associate chief physicians, 10 attending physicians, and 15 resident physicians, including 16 doctoral postgraduate students and 24 master’s postgraduate students. Over the past nearly ten years, the Cardiovascular Surgery Department has routinely performed more than 1,000 cardiac operations of various types annually. The number and complexity of operations have remained among the top three in the national children’s hospital system, with an operative success rate of over 98%. Comprehensive treatment can routinely be provided for neonates, low-weight infants, and critically ill patients with complex congenital heart disease. The department 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 nationwide, 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, sliding tracheoplasty for O-ring tracheal stenosis, and external stenting for tracheomalacia. At present, the volume and quality of operations remain among the leading levels nationwide, and the center was also among the earlier institutions in China to perform secondary interventions after failed tracheoplasty. Thoracoscopic surgery and da Vinci robot-assisted thoracoscopic surgery are also actively performed, providing patients with more treatment options. At present, Cardiovascular Surgery has established an integrated diagnosis and treatment system consisting of prenatal diagnosis and counseling; cardiovascular specialty and congenital heart disease outpatient services; the cardiovascular ward; cardiac imaging diagnosis; surgery; postoperative intensive care; and 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 recognized as major clinical technology projects in the Guangzhou region.

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 non-surgical diseases, such as fulminant myocarditis, cardiogenic shock and multiorgan failure caused by various factors; in the rescue and treatment of pulmonary hypertensive crises caused by idiopathic pulmonary arterial hypertension and persistent pulmonary hypertension of the newborn; and in the support and treatment of multiorgan 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 nutrition, formulate nutrition management strategies, and conduct multiple studies on the perioperative and medium- and long-term postoperative nutritional status of children with congenital heart disease. The unit routinely performs electronic bronchoscopy examinations 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 technology in children after congenital heart surgery. As a principal member department of the hospital’s ECMO collaboration group, it guides other departments in achieving good results in children with non-cardiac diseases. Pediatric cardiopulmonary exercise function testing has been developed, filling a gap in China. In 2023, it was designated as a construction unit for a National Standardized Cardiac Rehabilitation Center and as a National Standardized Pulmonary Vascular Disease Demonstration Center.

The Department of Pediatric Cardiology was established in the 1980s and was one of the earlier tertiary pediatric disciplines in China. After more than 30 years of discipline development, Pediatric Cardiology has grown into a nationally renowned pediatric cardiac 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 has been among the first in China to perform pediatric atrial septostomy and cardiac catheterization. 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, its current interventional treatments for congenital heart disease include not only interventions for common congenital heart diseases, but also pulmonary artery stent implantation, occlusion of pulmonary sequestration combined with major aortopulmonary collateral arteries, and interventional treatment of coronary artery fistulas and pulmonary arteriovenous fistulas, among other methods. Approximately 400 cardiovascular interventional diagnostic and treatment procedures are performed annually, with an overall technical success rate of over 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 dedicated to extracorporeal circulation management during surgery for complex congenital heart disease in infants and young children, as well as ECMO operation and management for critically ill children in our hospital. It actively optimizes tubing miniaturization and downsizing and has developed low-prime and bloodless-prime techniques. More than 50 ECMO cases are completed each year, placing it among the leading pediatric hospitals nationwide.

Introduction to Special Technologies 1. Surgical treatment of neonatal, low-weight, critically ill, and complex congenital heart disease: High-difficulty and complex pediatric cardiac surgeries, including the double-switch operation, Senning, Rastelli, Cone, DKS, Ross/Konno, Ross II, modified Nikaidoh, Norwood operations, and pulmonary vascular unifocalization, are widely performed. 2. Comprehensive treatment of pulmonary atresia/ventricular septal defect/major aortopulmonary collateral arteries: Over the past ten years, staged or one-stage corrective surgery has been completed for more than 500 patients with pulmonary atresia complicated by ventricular septal defect. The department has particular expertise in the surgical treatment of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCAs, i.e., 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%, making the number and outcomes of surgical treatments for this condition rank first nationwide, with a surgical treatment success rate reaching an internationally advanced level. For three consecutive years, “master classes” and “refinement classes” have been held in China to promote surgical treatment strategies for this complex malformation, attracting children from more than 20 provinces and cities nationwide for treatment. 3. Minimally invasive surgery for congenital heart disease: Minimally invasive procedures have been widely performed, including median and axillary mini- and small-incision surgery, thoracoscopic surgery, and other techniques. 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 Cardiac Center, enabling ECMO technology to be widely promoted in all ICUs throughout the hospital. Over the past three years, the number of ECMO cases hospital-wide has increased by leaps and bounds. The supported disease categories have expanded from the original indications of only low cardiac output after cardiac surgery and fulminant myocarditis to include various types of severe pneumonia, congenital diaphragmatic hernia, persistent pulmonary hypertension of the newborn, and others. 5. Pediatric cardiopulmonary exercise testing (CPET): 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, Kawasaki disease, and other conditions. More than 100 healthy children also participated in the examinations. The testing not only guides exercise rehabilitation for cardiac patients, but also provides great reference value for the differential diagnosis of symptoms such as chest pain and chest tightness. 6. Comprehensive evaluation and diagnosis and treatment technology for Kawasaki disease: Kawasaki disease is one of the main diseases treated in pediatric cardiology outpatient and inpatient services. More than 600 patients are admitted annually, including many complex and referred cases. After years of effort, Pediatric Cardiology has developed a systematic evaluation and 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-resistant Kawasaki disease, and severe complications of Kawasaki disease, such as giant coronary artery aneurysms and Kawasaki disease shock syndrome. Its expertise is at a leading level in the province and an advanced level nationally.