title: [Six-year experience with cardiac surgery in adults with congenital heart disease].
abstract: BACKGROUND
  Increasing number of adults with congenital heart disease (ACHD) require reoperation or primary repair. To define risk and outcome of operations of ACHD performed in adult cardiac surgery.
  
  
  METHODS
  Between 2005-2010 we operated on 459 patients with ACHD, aged 40.4 +/- 15 years. Operations of ACHD represented 9.5% of 4854 cardiac operations in our department.
  
  
  RESULTS
  The 30-days mortality was 1.1%, hospital mortality was 1.52%, long-term mortality among discharged patients was 1.3%. Reoperations after surgery in childhood represented 39%, repeated reoperations 9%, operations of 3 or 4 valves 2.6%. Robotic surgery or minithoracotomy was performed in 9%. Pulmonary hypertension was present in 11.3%, NYHA III-IV in 30%. The risk factors of mortality were: NYHA class III-IV (p < 0.001), cyanosis (p < 0.001), severe systolic dysfunction of left (p = 0.006) or right ventricle (p < 0.001).We did not confirm increased risk in older patients, women, pulmonary hypertension, reoperations and operations of 3-4 valves.
  
  
  CONCLUSIONS
  Excellent surgical results among older adults with CHD were achieved by the co-operation of paediatric cardiac surgeon within the experienced centre for adult cardiac surgery. The highest risk was found in patients with NYHA class Ill-IV, cyanosis and ventricular dysfunction.
authors.affiliation: Oddelení kardiochirurgie, Kardiocentrum Nemocnice Na Homolce, Praha. jana.popelova@homolka.cz
authors.forename: Jana
authors.initials: J
authors.lastname: Popelová
authors.forename: Stepán
authors.initials: S
authors.lastname: Cerný
authors.forename: Roman
authors.initials: R
authors.lastname: Gebauer
authors.forename: Petr
authors.initials: P
authors.lastname: Pavel
authors.forename: Pavel
authors.initials: P
authors.lastname: Jehlicka
mesh_terms: D000328:Adult; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D012307:Risk Factors; D012371:Robotics; D015996:Survival Rate