title: Midterm results of surgical intervention for congenital heart disease in adults: an Italian multicenter study.
abstract: OBJECTIVE
  We have analyzed, in a clinical multicenter study, the effect of cardiac surgery in adults with congenital heart disease in Italy.
  
  
  METHODS
  We collected clinical data from 856 patients aged 19 years or older who underwent surgical intervention from January 1, 2000, to December 31, 2004. Patients were divided into 3 surgical groups: group 1, palliation (3.1%); group 2, repair (69.7%); and group 3, reoperation (27.4%).
  
  
  RESULTS
  Preoperatively, 34.6% of patients were in New York Heart Association class I, 48.4% were in class II, 14.2% were in class III, and 2.8% were in class IV. Sinus rhythm was present in 83%. There were 1179 procedures performed in 856 patients (1.37 procedures per patient), with a hospital mortality of 3.1%. Overall mean intensive care unit stay was 2.3 days (range, 1-102 days). Major complications were reported in 247 (28.8%) patients, and postoperative arrhythmias were the most frequent. At a mean follow-up of 22 months (range, 1 month-5.5 years; completeness, 87%), late death occurred in 5 (0.5%) patients. New York Heart Association class was I in 79.3%, II in 17.6%, and III in 2.9%, and only 1 (0.11%) patient was in class IV. Overall survival estimates are 82.6%, 98.9%, and 91.8% at 5 years for groups 1, 2, and 3, respectively. Freedom from adverse events at 5 years is 91% for acyanotic patients versus 63.9% for preoperative cyanotic patients (P < .0001).
  
  
  CONCLUSIONS
  Surgical intervention for congenital heart disease in adults is a safe and low-risk treatment. However, patients presenting with preoperative cyanosis show a higher incidence of late adverse events and complications.
authors.affiliation: Pediatric and Congenital Cardiac Surgery Unit, Centro Gallucci, University of Padua Medical School, Padua, Italy.
authors.forename: Massimo A
authors.initials: MA
authors.lastname: Padalino
authors.forename: Simone
authors.initials: S
authors.lastname: Speggiorin
authors.forename: Giulio
authors.initials: G
authors.lastname: Rizzoli
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Crupi
authors.forename: Vladimiro L
authors.initials: VL
authors.lastname: Vida
authors.forename: Massimo
authors.initials: M
authors.lastname: Bernabei
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gargiulo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giamberti
authors.forename: Francesco
authors.initials: F
authors.lastname: Santoro
authors.forename: Carlo
authors.initials: C
authors.lastname: Vosa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pacileo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
authors.forename: Luciano
authors.initials: L
authors.lastname: Daliento
authors.forename: Giovanni
authors.initials: G
authors.lastname: Stellin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D003625:Data Collection; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000145:classification / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome