title: [Adult congenital heart program in a tertiary care facility of pediatric cardiology].
abstract: BACKGROUND
  Owing to excellent survival following primary repair over 80% of congenital cardiac patients reach adulthood, half of them requiring continuous specialist care and one-third needing further reoperation. The ample variety and complexity of lesions warrant individualised treatment strategy.
  
  
  OBJECTIVE
  This study focuses on grown-up congential heart (GUCH) programme in the settings of a tertiary pediatric cardiac centre.
  
  
  METHODS
  Patients underwent corrective surgical procedures in pediatric facilities (theatre, ICU, wards) with a close involvement of adult cardiology/anaesthetic team. Patients were divided into simple/complex groups.
  
  
  RESULTS
  Simple group of comprised patients (n = 20) having ASD-II (18/20) sinus venosus ASD (2/20) repair without morbidity/mortality from right subaxillary thoracotomy in 17/20. Complex group (n = 20): corrective surgery for tetralogy of Fallot (6), LVOT-aortic valve repairs (4), allograft conduit exchange (3), TCPC (3), miscellaneous procedures (4) were performed as reoperations in 16/20 at 16.1 +/- 8.1 years following previous operations (median: 1.96, range 1-4). Postoperative right ventricle- (1), acute renal (1) failure and ARDS (1) fully recovered. One patient was lost for multi-organ-failure due to low cardiac output syndrome caused by chronic RV failure. Preoperative cyanosis was a risk factor for postoperative complications (p = 0.01). All survivors are symptom-free. No significant difference in ITU stay/LOS was observed between simple and complex groups.
  
  
  CONCLUSIONS
  This study represents the initial experience of authors with GUCH. The number of GUCH patients is expected to rise with an upgrade shift in surgical complexity and severity requiring a multidisciplinary approach. It is advocated that complex GUCH cases should be performed by teams experienced in congenital reconstructive surgery. Patients following complex GUCH procedures have a comparable hospital course to patients undergoing simple cardiac operations.
authors.affiliation: Gottsegen György Országos Kardiológiai Intézet, Gyermekszív Központ, Budapest. kiraly@kardio.huj
authors.forename: László
authors.initials: L
authors.lastname: Király
authors.forename: András
authors.initials: A
authors.lastname: Temesvári
authors.forename: Andrea
authors.initials: A
authors.lastname: Székely
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Prodán
authors.forename: Csilla
authors.initials: C
authors.lastname: Liptai
authors.forename: László
authors.initials: L
authors.lastname: Szudi
authors.forename: István
authors.initials: I
authors.lastname: Hartyánszky
authors.forename: Csilla
authors.initials: C
authors.lastname: Havrancsik
authors.forename: András
authors.initials: A
authors.lastname: Szatmári
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D008297:Male; D012307:Risk Factors; D013908:Thoracotomy; D016896:Treatment Outcome