Congenital heart disease in adults: an 8-year surgical experience in a medium-volume cardiac center.
OBJECTIVE
We report our 8-year experience with surgery for congenital heart disease in adults in a medium-volume surgical center.


METHODS
We collected data of 161 consecutive patients who underwent 230 procedures from January 1997 to December 2004. Surgical procedures were divided into two groups: repair (85.7%) and reoperation (14.3).


RESULTS
There was only one in-hospital death (Fontan revision, in reoperation group). At a mean follow-up time of 56 +/- 30 months, overall freedom from any kind of complication is 76.5%. Cox analysis showed that incremental risk factors were preoperative cyanosis, reoperation, and length of ICU stay (hazard ratio = 4.47, 3.34 and 1.49, respectively; P < 0.001 in all), whereas decremental risk factors were preoperative New York Heart Association class 1 (hazard ratio = 0.328, P < 0.001) and surgery for 'septal defect' (hazard ratio = 0.26, P = 0.02).


CONCLUSIONS
Surgery for congenital heart disease in adults seems to be an overall well-tolerated and a low-risk treatment, with overall good mid-term clinical results.
Padalino
Massimo A
MA
Pediatric and Congenital Cardiac Surgery Unit, University of Padua Medical School, Padua, Italy. massimo.padalino@unipd.it
Cogo
Paola E
PE
Daliento
Luciano
L
Speggiorin
Simone
S
Vida
Vladimiro L
VL
Maschietto
Nicola
N
Reffo
Elena
E
Stellin
Giovanni
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D003490:Cyanosis / Q000209:etiology / Q000601:surgery; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult