Outcome of complex adult congenital heart surgery in the developing world.
BACKGROUND
There is scanty information on the outcome of adult congenital heart disease surgery from the developing world.


METHODS
This was a retrospective chart review of the surgical outcome of 153 adults with congenital heart disease over a 5-year period. Surgical atrial septal defect closure was considered "simple" while all other surgeries were considered "complex."


RESULTS
There were 102 patients in the "simple" group and 51 in the "complex" group. Only three (2%) patients had prior operations. The "complex" group had longer bypass time and cross clamp time. Intensive care unit stay, ventilation time, and inotrope administration were longer. Major complications were more common and there were two deaths in the "complex" group. Age more than 30 years, cyanosis, and New York Heart Association class more than II were predictors of longer stay in the intensive care unit. Surgical repair of Tetralogy of Fallot in adults tended to have a longer ventilation time and intensive care unit stay with a mortality of 4%. At follow up, all patients were in New York Heart Association class I or II. Improvement of the functional class with negligible adverse events was noted in both groups.


CONCLUSIONS
A retrospective evaluation of 153 adults with congenital heart disease who underwent open heart surgery at a single center in India showed strikingly fewer reoperations compared with large European studies. There was a similar prevalence of complex lesions. Surgical mortality was low, and long-term functional outcome was gratifying.
Departments of Pediatric Cardiology Pediatric Cardiac Surgery, The Madras Medical Mission, Chennai, India.
Ganesh Kumar
GK
Gnanappa
Madhusudan
M
Ganigara
Atul
A
Prabhu
Suraj Kumar
SK
Varma
Uday
U
Murmu
Roy
R
Varghese
John
J
Valliatu
Raghavan Nair Suresh
RN
Kumar
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D003422:Critical Care; D003906:Developing Countries / Q000706:statistics & numerical data; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007194:India / Q000453:epidemiology; D007902:Length of Stay; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D012086:Reoperation; D012121:Respiration, Artificial; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult