Document Detail

25-year mortality after surgical repair of congenital heart defect in childhood. A population-based cohort study.
MedLine Citation:
PMID:  1744959     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine long-term survival and the cause of death after repair of one of eight congenital heart defects in childhood.
DESIGN: Cohort study.
SETTING: General community.
PARTICIPANTS: All Oregon residents with one of eight congenital heart defects, which was repaired surgically between 1958 and 1989 when the patient was aged 18 years or younger, including (1) tetralogy of Fallot; (2) isolated ventricular septal defect; (3) isolated atrial septal defect; (4) coarctation of the aorta; (5) aortic valvular stenosis; (6) pulmonary valvular stenosis; (7) transposition of the great arteries; and (8) patent ductus arteriosus. Follow-up of this cohort of 2701 individuals was obtained from 94%.
MAIN OUTCOME MEASURE: Mortality from cardiac and noncardiac causes.
RESULTS: Age at surgery and operative mortality have decreased significantly over the last 30 years. Late cardiac mortality at 25 years after surgery was 5% for tetralogy of Fallot and isolated ventricular septal defect, 10% for coarctation of the aorta, 17% for aortic stenosis, 5% for pulmonic stenosis, and less than 1% for patent ductus arteriosus; there were no late cardiac deaths after atrial septal defect repair. For transposition, late cardiac mortality was 15% at 15 years after the Mustard operation and was 2% at 10 years after the Senning operation.
CONCLUSION: Surgical repair of most congenital heart defects is associated with lingering cardiac mortality, particularly for aortic stenosis, coarctation, and transposition.
C D Morris; V D Menashe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JAMA     Volume:  266     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-01-14     Completed Date:  1992-01-14     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3447-52     Citation Subset:  AIM; IM    
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MeSH Terms
Aortic Coarctation / mortality,  surgery
Aortic Valve Stenosis / mortality,  surgery
Cardiac Surgical Procedures / trends
Cohort Studies
Heart Defects, Congenital / mortality*,  surgery*
Mortality / trends
Oregon / epidemiology
Population Surveillance
Tetralogy of Fallot / mortality,  surgery
Transposition of Great Vessels / mortality,  surgery
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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