Progress in Late Results Among Pediatric Cardiac Surgery Patients: A Population-Based 6-Decade Study With 98% Follow-Up

• Published in: Circulation (New York, N.Y.) N.Y.), 2015-01, Vol.131 (4), p.347-353
• Main Authors: Raissadati, Alireza, Nieminen, Heta, Jokinen, Eero, Sairanen, Heikki
• Format: Article
• Language: English
• Subjects: Cardiac Surgical Procedures - mortality; Cardiac Surgical Procedures - trends; Child; Child, Preschool; Female; Finland - epidemiology; Follow-Up Studies; Heart Defects, Congenital - epidemiology; Heart Defects, Congenital - mortality; Heart Defects, Congenital - surgery; Humans; Male; Pediatrics - trends; Population Surveillance - methods; Registries; Retrospective Studies; Survival Rate - trends; Time Factors
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.114.011190

BACKGROUND—Surgical treatment of congenital cardiac defects in Finland started >60 years ago. We analyzed the survival of all the pediatric cardiac surgery patients operated on before 2010. METHODS AND RESULTS—Data were obtained retrospectively from a pediatric cardiac surgery database. Patient status was received from the Finnish Population Registry. Survival was determined with the Kaplan–Meier method, and the survival rate was compared with a sex- and age-matched general population. Between 1953 and 2009, 13 876 cardiac operations were performed on 10 964 pediatric patients in Finland. Follow-up coverage was 98%. The 60-year survival for the entire study was 70% versus 86% for the general population. The number and proportion of severe cardiac defects increased in the 2000s. The long-term survival of patients with severe defects improved significantly across decades. For instance, the 22-year survival rate of patients with transposition of the great arteries operated on in 1953 to 1989 and in 1990 to 2009 improved from 71% to 93% (hazard ratio for death, 0.29; 95% confidence interval, 0.17–0.49; P