TY - JOUR

T1 - Nineteen Years of Adult Congenital Heart Surgery in a Single Center

AU - Perinpanayagam, Madurra

AU - Larsen, Signe H

AU - Emmertsen, Kristian

AU - Møller, Marianne B

AU - Hjortdal, Vibeke E

PY - 2017/3

Y1 - 2017/3

N2 - BACKGROUND: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort.METHODS: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System.RESULTS: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%).CONCLUSION: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

AB - BACKGROUND: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort.METHODS: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System.RESULTS: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%).CONCLUSION: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cardiac Surgical Procedures/statistics & numerical data

KW - Databases, Factual

KW - Denmark/epidemiology

KW - Female

KW - Forecasting

KW - Heart Defects, Congenital/epidemiology

KW - Hospital Mortality/trends

KW - Hospitals, University/statistics & numerical data

KW - Humans

KW - Male

KW - Middle Aged

KW - Morbidity/trends

KW - Odds Ratio

KW - Postoperative Complications/epidemiology

KW - Risk Factors

KW - Survival Rate/trends

KW - Young Adult

U2 - 10.1177/2150135116682454

DO - 10.1177/2150135116682454

M3 - Journal article

C2 - 28329459

VL - 8

SP - 182

EP - 188

JO - World journal for pediatric & congenital heart surgery

JF - World journal for pediatric & congenital heart surgery

SN - 2150-1351

IS - 2

ER -