Surgical management of congenital heart diseases in the Russian Federation: national registry data for 2024

Introduction. Congenital heart diseases (CHDs) remain a leading cause ofinfant mortality and disability, underlining their high medico-social significance.In the context of rapid technological advancements, evolving demographicindicators, and improvements in prenatal diagnostics, systemic monitoring of treatment outcomes at the national level has become critically important. The national registry facilitates an objective assessment of current cardiac surgical care effectiveness nationwide, helps identify regional trends, and determines priority areas for the implementation of modern hybrid and endovascular protocols. Objective. To evaluate the current status and outcomes of surgical treatment for congenital heart diseases (CHD) in the Russian Federation based on the 2024 national multicenter registry data. Methods. A retrospective analysis of 14,640 surgical procedures performed across 31 cardiac surgery centers was conducted. The RACHS II scoring system was utilized for risk stratification. The study assessed hospital mortality rates, pathology distribution, and the efficacy of various surgical strategies. Results. The overall hospital mortality rate was 1.42 %. Endovascular procedures accounted for a significant proportion (38.4 %) of interventions. In the interventional arrhythmia segment (n = 1,342), zero mortality was achieved. The highest risk remains in the neonatal group (6.6 % mortality). Analysis of palliative care revealed the superiority of the hybrid approach: ductal stenting in duct-dependent patients showed half the mortality rate (4.95 %) compared to the surgical systemic-to-pulmonary artery shunt (9.74 %). Complex reconstructions (Norwood procedure) remain a high-risk area. Conclusion. The national pediatric cardiac surgery registry demonstrates high efficacy and safety for routine interventions. There is a distinct trend towards replacing open surgery with endovascular techniques. Centralization of care for critical CHDs in expert centers and the adoption of hybrid technologies are key factors for further improving outcomes.