Interventional Treatment of Patients With Congenital Heart Disease: Nationwide Danish Experience Over 39 Years
Research output: Contribution to journal › Journal article › Research › peer-review
BACKGROUND: The treatment of congenital heart (CHD) has changed rapidly.
OBJECTIVES: The authors reviewed CHD treatment through a 39-year nationwide population-based study on congenital heart surgery and catheter-based interventions, unbiased by referral patterns.
METHODS: Using medical registries, the authors identified children (<18 years of age) treated for CHD in Denmark from 1977 to 2015, their need for reinterventions, and their long-term survival. Ten controls per patient, matched by sex and year of birth, allowed comparison with the background population. Survival was described using Kaplan-Meier curves.
RESULTS: A total of 9,372 patients underwent 11,968 cardiac surgeries and 1,912 catheter-based interventions. Median age at first procedure decreased from 3.4 years (5th and 95th percentiles: 0.01 to 15.4 years) in 1977 to 1989 (period 1), 0.8 years (5th and 95th percentiles: 0.003 to 13.8 years) in 1990 to 2002 (period 2), and to 0.6 years (5th and 95th percentiles: 0.0 to 14.9 years) in 2003 to 2015 (period 3). More patients were born preterm (<37 weeks) in period 3 compared with those in period 1 (18.5% vs. 6.7%). Catheter-based interventions, not recorded before 1990, were increasingly used as the initial procedure in 5.8% of patients in period 2 and 25.9% of patients in period 3. An increasing part of the population did not undergo surgery at all (4.8% in period 2; 24.0% in period 3). Thirty-day survival increased from 97% (period 1) to 98% (period 2) to 100% (period 3). Ten-year survival increased from 80% (period 1) to 87% (period 2) to 93% (period 3). Compared with the background population, CHD was associated with lower survival in all 3 time periods.
CONCLUSIONS: Interventional treatment of CHD has evolved from 1977 to 2015 and is now performed on younger and more preterm patients, often with catheter-based interventions. However, compared with the background population, survival remains significantly reduced.
Original language | English |
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Journal | Journal of the American College of Cardiology |
Volume | 69 |
Issue number | 22 |
Pages (from-to) | 2725-2732 |
Number of pages | 8 |
ISSN | 0735-1097 |
DOIs | |
Publication status | Published - 6 Jun 2017 |
Externally published | Yes |
- Adolescent, Cardiac Catheterization/methods, Cardiac Surgical Procedures, Child, Child, Preschool, Denmark/epidemiology, Follow-Up Studies, Forecasting, Heart Defects, Congenital/mortality, Humans, Infant, Infant, Newborn, Registries, Retrospective Studies, Risk Factors, Survival Rate/trends, Treatment Outcome
Research areas
ID: 241828524