title: Outcomes in adult congenital heart surgery: analysis of the Society of Thoracic Surgeons database.
abstract: OBJECTIVE
  Outcomes data for adults undergoing congenital heart surgery are limited. Previous analyses used administrative data or focused on single-center outcomes. We describe the most common operations, patient characteristics, and postoperative outcomes using a multicenter clinical database.
  
  
  METHODS
  The study included adults (aged ≥ 18 years) listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2000-2009). We describe patient characteristics and morbidity and mortality, and examine congenital procedures in the Society of Thoracic Surgeons Adult Cardiac Surgery Database to permit consideration of the primary dataset within a broader context.
  
  
  RESULTS
  A total of 5265 patients (68 centers) from the Society of Thoracic Surgeons Congenital Heart Surgery Database were included. Patients' median age was 25 years (interquartile range, 20-35). Common preoperative risk factors included noncardiac abnormalities (17%) and arrhythmia (14%). Overall, in-hospital mortality was 2.1%, 27% had 1 or more complication, and median length of stay was 5 days. Common operations included right ventricular outflow tract procedures (21%) and pacemaker/arrhythmia procedures (20%). We further evaluated cardiopulmonary bypass procedures in more than 100 patients. Mortality ranged from 0% (atrial septal defect repair) to 11% (Fontan revision/conversion). Separate evaluation of the Society of Thoracic Surgeons Adult Cardiac Surgery Database revealed 39,872 adults undergoing congenital heart operations.
  
  
  CONCLUSIONS
  Most adult congenital heart operations listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database are performed in the third to fourth decades of life; approximately half are for right heart pathology or arrhythmia. Many patients have complications, but mortality is low with the exception of those undergoing Fontan revision/conversion. Many more adults undergoing congenital heart surgery are entered into the Society of Thoracic Surgeons Adult Cardiac Surgery Database.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Louisville, Louisville, KY, USA. cmascio@louisvilleheartsurgery.com
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Mascio
authors.forename: Sara K
authors.initials: SK
authors.lastname: Pasquali
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Jacobs
authors.forename: Marshall L
authors.initials: ML
authors.lastname: Jacobs
authors.forename: Erle H
authors.initials: EH
authors.lastname: Austin
mesh_terms: D000328:Adult; D000367:Age Factors; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D019992:Databases as Topic; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D012955:Societies, Medical / Q000706:statistics & numerical data; D013903:Thoracic Surgery / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult