title: Perioperative care of the adult with congenital heart disease in a free-standing tertiary pediatric facility.
abstract: Adult patients with congenital heart disease are presenting more frequently for cardiac surgery. Frequently, pediatric congenital heart surgeons perform these procedures at pediatric hospitals. Between July 1995 and June 2000, a retrospective review of adult patients (> or = 18 years old) who had undergone cardiothoracic operations was performed. A total of 112 operations were performed and divided into two groups--81 cardiac operations in 79 patients and 31 noncardiac operations in 23 patients. One patient had a cardiac and noncardiac operation performed. The overall early operative mortality was 6% (6/101). There were 3 late deaths. New-onset cardiac arrhythmias requiring treatment were diagnosed after 5/81 (6%) cardiac operations. Six of 79 (7%) patients were diagnosed with postoperative clinical depression. An acceptable mortality can be achieved when adult patients undergo cardiothoracic operations at a pediatric facility. New-onset arrhythmias necessitating treatment are relatively common, and postoperative clinical depression should be anticipated.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Mott
authors.forename: C D
authors.initials: CD
authors.lastname: Fraser
authors.forename: E D
authors.initials: ED
authors.lastname: McKenzie
authors.forename: L I
authors.initials: LI
authors.lastname: Bezold
authors.forename: D B
authors.initials: DB
authors.lastname: Andropoulos
authors.forename: G J
authors.initials: GJ
authors.lastname: Reul
authors.forename: C H
authors.initials: CH
authors.lastname: Miranda
authors.forename: S L
authors.initials: SL
authors.lastname: Bedford
authors.forename: T F
authors.initials: TF
authors.lastname: Feltes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006776:Hospitals, Pediatric; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012086:Reoperation; D016019:Survival Analysis; D013781:Texas; D016896:Treatment Outcome