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Ten-year experience with surgical treatment of adults with congenital cardiac disease

The number of adults with congenital cardiac disease continues to increase, and adult patients are now more numerous than paediatric patients. We sought to identify risk factors for perioperative death and report our results with surgical management of adult patients with congenital cardiac disease....

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Published in:Cardiology in the young 2011-02, Vol.21 (1), p.39-45
Main Authors: Wauthy, Pierre, Massaut, Jacques, Sanoussi, Ahmed, Demanet, Hélène, Morissens, Marielle, Damry, Nasroolla, Dessy, Hughes, Malekzadeh-Milani, Sophie G., Deuvaert, Frank E.
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cited_by cdi_FETCH-LOGICAL-c371t-e1108345c373f82dfa411d8152bc8732b6beefaaa172555f4b8d4aab350b9c3
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container_title Cardiology in the young
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creator Wauthy, Pierre
Massaut, Jacques
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Deuvaert, Frank E.
description The number of adults with congenital cardiac disease continues to increase, and adult patients are now more numerous than paediatric patients. We sought to identify risk factors for perioperative death and report our results with surgical management of adult patients with congenital cardiac disease. We retrospectively analysed in-hospital data for 244 consecutive adult patients who underwent surgical treatment of congenital cardiac disease in our centre between January, 1998 and December, 2007. The mean patient age was 27.2 plus or minus 11.9 years, 29% were in functional class III or IV, and 25% were cyanosed. Of the patients, half were operated on for the first time. A total of 61% of patients underwent curative operations, 36% a reoperation after curative treatment, and 3% a palliative operation. Overall mortality was 4.9%. Predictive factors for hospital death were functional class, cyanosis, non-sinus rhythm, a history of only palliative previous operation(s), and an indication for palliative treatment. Functional class, cyanosis, type of initial congenital cardiac disease (single ventricle and double-outlet right ventricle), and only palliative previous operation were risk factors for prolonged intensive care stay (more than 48 hours). The surgical management of adult patients with congenital cardiac disease has improved during recent decades. These generally young patients, with a complex pathology, today present a low post-operative morbidity and mortality. Patients having undergone palliative surgery and reaching adulthood without curative treatment present with an increased risk of morbidity and mortality. Univentricular hearts and double-outlet right ventricles were associated with the highest morbidity.
doi_str_mv 10.1017/S1047951110001332
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subjects Adult
Belgium - epidemiology
Cardiac arrhythmia
Cardiac Surgical Procedures
Female
Follow-Up Studies
Heart Defects, Congenital - mortality
Heart Defects, Congenital - surgery
Humans
Infant mortality
Male
Medical imaging
Postoperative period
Pulmonary arteries
Retrospective Studies
Standard deviation
Survival Rate - trends
Time Factors
Treatment Outcome
title Ten-year experience with surgical treatment of adults with congenital cardiac disease
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