Introduction of the Division of Cardiovascular Surgery in the Department of Surgery at the National Cheng Kung University Hospital (心臟血管外科)
By Jun-Neng Roan, MD, PhD
March 2, 2020
The Division of Cardiovascular Surgery at the National Cheng Kung University Hospital (NCKUH) was established in 1988. The founding dean, Prof. Kun-Yen Huang, collaborated with Prof. Yu-Jen Young and Dr. Lao-Shen Lin (林老生醫師) to establish the initial cardiovascular team. On September 2, 1988, Prof. Yu-Jen Young, the first Section Chief and first Director of Surgery Department, performed the first open-heart surgery at the hospital. The surgery, which was a great success, involved repairing a ventricular septal defect. The patient was discharged five days postoperatively. There was a total of thirty open-heart surgery cases in the starting year (1988). The number of cases grew steadily in the following years and there have been over 240 cases per year in recent years, Figure 1. The first resident doctor, Dr. Chwan-Yau Luo, came in 1989 for training in cardiovascular surgery. He became the second Section Chief in 2002. There has been many other outstanding cardiovascular surgeons trained in the Division of Cardiovascular Surgery at the NCKUH. In 2018, Dr. Jun-Neng Roan succeeded as the third Section Chief in the Division.
As a national medical center in Taiwan, the Division of Cardiovascular Surgery provides various kinds of surgery services. The success rate is 95.5% for valve replacement surgery and 98% for coronary artery bypass surgery. The freedom from reoperation after mitral valve repair at 10 years is over 95%. Except for complex congenital heart diseases, the success rate for congenital heart surgery was approximately 95%.
There are 85-110 extracorporeal membrane oxygenation (ECMO) cases per year. The program for ventricular assist devices started in 2012 with good results. The heart transplantation program, led by Prof. Chwan-Yau Luo, started in December 2005, Figure 2. Being a low-volume heart transplantation center with 3-8 cases per year, the number of cases keeps accumulating. There is a total of 68 cases until December 2019. Our heart transplantation outcomes are comparable to the international data. the one-year, three-year, and 10-year survival rates are 90%, 83%, and 73%, respectively.
The program for transcatheter aortic valve surgery started in 2014. More than forty cases have been reported to date, with good results.
The operation mortality rate for acute type A aortic dissection ranges between 8% and 15% in the recent decade. Other major open aortic surgeries, such as thoracoabdominal aneurysms, are also performed with good results. The endovascular therapy program started in early 2006. There have been over forty cases of thoracic and abdominal operations per year.
The Division of Cardiovascular Surgery at the NCKUH attempted to be the best in every field. Minimally invasive programs (including robotic and mini-thoracotomy operations) will begin next year. Our group also has a good connection with other outstanding medical centers in the US, Canada, and United Kindom. We also share the responsibility of global citizens in cardiovascular education. There are other important development goals in both clinical and basic research programs. The Division of Cardiovascular Surgery at the NCKUH always provides our patients with the best care.
Figure 1. Celebration party for the 1000th open heart surgery in National Cheng Kung University Hospital in 1995. Founding Dean, prof. Kun-Yen Huang (left), prof. Yu-Jen Young (middle), and prof. Jyh-Hong Chen (right, previous chief of Division of Cardiology).
Figure 2. The first heart transplantation surgery performed by prof. Yu-Jen Young (right) and prof. Chwan-Yau Luo (left) on December 14, 2005. The patient discharged on postoperation day 15 and was doing well at last follow up on March/1/2020.