Risk of surgery for congenital heart disease in the adult: a multicentered European study.
BACKGROUND
Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population.


METHODS
Data relative to the hospital course of 2,012 adult patients (age > or = 18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection.


RESULTS
Mean age at surgery was 34.4 +/- 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75%), followed by reoperations (464 patients, 23.1%) and palliative procedures (39 patients, 1.9%). Six hundred forty-nine patients (32.2%) required surgical closure of an isolated ostium secundum atrial septal defect. Overall hospital mortality was 2%. Preoperative cyanosis, arrhythmias, and NYHA class III-IV, proved significant risk factors for hospital mortality. Follow-up data were available in 1,342 of 1,972 patients (68%) who were discharged home. Late deaths occurred in 6 patients (0.5%). Overall survival probability was 97% at 60 months, which is higher for corrective procedures (98.2%) if compared with reoperations (94.1%) and palliations (86.1%).


CONCLUSIONS
Surgical treatment of CHD in adult patients, in specialized cardiac units, proved quite safe, beneficial, and low-risk.
Vida
Vladimiro L
VL
Pediatric Cardiac Surgery Unit, University of Padova, Padova, Italy.
Berggren
Hakan
H
Brawn
William J
WJ
Daenen
Willem
W
Di Carlo
Duccio
D
Di Donato
Roberto
R
Lindberg
Harald L
HL
Corno
Antonio F
AF
Fragata
Jose
J
Elliott
Martin J
MJ
Hraska
Viktor
V
Kiraly
Lazlo
L
Lacour-Gayet
François
F
Maruszewski
Bohdan
B
Rubay
Jean
J
Sairanen
Heikki
H
Sarris
George
G
Urban
Andreas
A
Van Doorn
Carin
C
Ziemer
Gerhard
G
Stellin
Giovanni
G
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012306:Risk