[Surgical management of congenital heart defects in adolescent and adult patients, between years 2001-2008].
The leading interventions due to congenital heart defects performed in adults are: (I) reconstructive operations, including: (a) newly diagnosed malformations, (b) previously adjudged to be inoperable defects, (c) so called "tardive" interventions due to pulmonary hypertension or right ventricle insufficiency. There is a growing number of (II) REDO operations, including: (a) correction of residual defects, (b) replacement of damaged or outgrown homografts, (c) recoarctation (aneurysm, dissection) of the aorta after surgical or catheter interventions, (d) Ross procedure, valve replacements due to previously performed aortic valvulotomy/valvuloplasty or corrections of different malformations (e.g. TGA).


RESULTS
166 of all 4496 operations were performed in adolescents and adults (age: 16-52 years, mean: 28 years) between years 2001-2008. The distribution of these interventions: Ia: 77, Ib: 15, Ic: 4, IIa: 11, IIb: 22, IIc: 9, IId: 28. Mortality rates were the following: 0 intraoperative, 4 early postoperative, 1 pulmonary hypertensive crisis, 1 malignant rhythm disturbances, 2 multi-organ failure.


CONCLUSIONS
The main risk factors are pulmonary hypertension and right ventricle failure. Complex surgical solutions do not mean extreme problems for a congenital cardiac surgeon, but earlier diagnosis and the use of ECMO during therapy may improve the results.
Hartyánszky
István
I
Gottsegen György Országos Kardiológiai Intézet Budapest Haller u. 29. 1096.
Székely
Andrea
A
Király
László
L
Prodán
Zsolt
Z
Mihályi
Sándor
S
Bodor
Gábor
G
Tamás
Csaba
C
Kassai
Imre
I
Fazakas
Levente
L
Temesvári
András
A
Szatmári
András
A
D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D003310:Cor Triatriatum / Q000601:surgery; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006349:Heart Valve Diseases / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D011666:Pulmonary Valve Stenosis / Q000601:surgery; D012086:Reoperation; D012720:Severity of Illness Index; D013771:Tetralogy of Fallot / Q000601:surgery; D014188:Transposition of Great Vessels / Q000601:surgery; D055815:Young Adult