title: Adult congenital heart disease: experience with the surgical approach.
abstract: OBJECTIVE
  To report the institution experience with the surgical treatment of adults with congenital heart disease due to the increasing number of these patients and the need for a better discussion of the subject.
  
  
  METHODS
  Retrospective analysis describing demographic data, risk factors and results.
  
  
  RESULTS
  191 patients between 16 and 74 years old were operated on. Primary correction was done in 171 cases, 93 (55%) for atrial septal defect repair. Among 20 (12%) reoperations, pulmonary valve replacement was done in six cases. The mean intensive care and hospital stay were 2.7 and 8.5 days respectively, significantly greater for the reoperated cases (P=0.001). The mean bypass and clamping times were 68.6 and 44.7 minutes respectively, greater for the reoperated cases (P<0.0001 and P=0.0003 respectively). Hospital mortality was 4.2% and male sex, functional class III-IV and older age at operation were predictive risk factors. Significant complications were more frequent in the reoperated cases (P<0.003), mainly atrial flutter and fibrillation. Among 183 patients discharged, 149 (82%) are being followed and atrial flutter and fibrillation are common. The mean functional class value improved significantly after operation (1.66 to 1.11; P<0.0001). The estimated survival was 96.2% in six years.
  
  
  CONCLUSIONS
  Heart surgery in adults with congenital heart disease can be accomplished with low mortality and functional class improvement. Immediate and late complications are frequent. Multicenter studies are important to better characterize this patient population in the country.
authors.forename: Fernando Tadeu Vasconcelos
authors.initials: FT
authors.lastname: Amaral
authors.forename: Alfredo José
authors.initials: AJ
authors.lastname: Rodrigues
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Manso
authors.forename: André
authors.initials: A
authors.lastname: Schmidt
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Kolachinski
authors.forename: Clovis
authors.initials: C
authors.lastname: Carbone
authors.forename: Ricardo Nilson
authors.initials: RN
authors.lastname: Sgarbieri
authors.forename: Walter Vilela de Andrade
authors.initials: WV
authors.lastname: Vicente
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001938:Brazil; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality; D004812:Epidemiologic Methods; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult