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In Finland, pediatric open-heart surgery is centralized in Helsinki, at New Children’s Hospital, where approximately 330 cardiac operations are performed annually, 240 of which are open heart surgeries. Approximately two-thirds of pediatric cardiac operations are performed on babies under 1 year old. Of these, less than half are under one month old.
Nowadays, all pediatric cardiac defects are handled with surgical treatment. Only 1–2 children are born in Finland each year who have such difficult structural deficiencies that a cardiac operation cannot help them.
In the last three years, the operative mortality rate in pediatric open-heart surgery in Finland has been 1.8 % on average. By international standards, this result is top class. For example, in Europe, the operative mortality rate was 3.7 % during the same period. The challenging nature of a cardiac operation is illustrated by the fact that a child’s heart is roughly the size of his or her own fist.
One of the most challenging cardiac operations is the Double Switch operation, which is performed on children whose heart ventricles and main vessels have congenitally switched location. In such a case, the circulation needs to be “switched” back twice, first at the atrium level and then at the artery level. Other extremely difficult operations include certain operations for pulmonary artery defects and complex cardiac operations of hearts with a single ventricle. The most common single ventricle heart is a heart suffering from hypoplastic left heart syndrome (HLHS). Systematic HLHS surgery started in Finland in 1995, so the oldest patients are now reaching adulthood. Approximately 20 HLHS surgeries are performed annually.
Pediatric cardiac operations are performed in cooperation with a number of units.