Anesthetic and perioperative outcome of teenagers and adults with congenital heart disease.
OBJECTIVE
To compare the perioperative outcome of patients >or=13 years old undergoing surgery for congenital heart disease in a children's hospital by a dedicated congenital heart surgery and anesthesia team with procedure-matched younger control patients.


METHODS
Retrospective medical record review study. From October 1997 to July 2000, medical records of all patients >12 years old requiring cardiopulmonary bypass were reviewed. A control group of patients <or=5 years old was reviewed, and 2 patients were matched to each older patient by diagnosis and surgical procedure. Data are reported as mean +/- SD. Older (study) patients were compared with younger (control) patients using t-test or chi square, with p <or= 0.05 significant.


METHODS
Medical school-affiliated tertiary-care children's hospital.


METHODS
Patients undergoing congenital heart surgery.


RESULTS
The study group (older patients) comprised 85 patients, and the control group (younger patients) comprised 170 patients. There were no intraoperative deaths. All major complications-cardiopulmonary resuscitation, neurologic injury, massive hemorrhage with sternotomy, femoral cannulation for emergent bypass, and severe episodes of hypotension on induction of anesthesia-occurred in older patients undergoing repeat sternotomy.


CONCLUSIONS
Mortality and major morbidity were low in both groups; however, all major intraoperative incidents occurred in older repeat sternotomy patients, suggesting increased perioperative risk for adverse outcomes in these patients.
Andropoulos
D B
DB
Division of Pediatric Cardiovascular Anesthesiology, Texas Children's Hospital and Baylor College of Medicine, Houston TX 77030-2399, USA. dra@bcm.tmc.edu
Stayer
S A
SA
Skjonsby
B S
BS
East
D L
DL
McKenzie
E D
ED
Fraser
C D
CD
D000293:Adolescent; D000328:Adult; D000758:Anesthesia; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications; D012189:Retrospective Studies