Document Detail


Successful surgical correction of congenital heart disease in adults: seven years' experience.
MedLine Citation:
PMID:  15847133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The long term consequences of untreated or residual/recurrent lesions pose unique challenges in the growing population of adults with congenital heart disease (CHD). This study summarizes the results of the surgical treatment of these patients. METHODS: From October 1997 to October 2004, 289 patients with CHD, aged 18-72 (35+/-13.6) years, 143 men and 146 women, presented for surgery to our unit. Thirty eight patients (13.15%) had 1 to 3 prior surgical procedures. Although 137 patients (47%) were asymptomatic (NYHA I), 117 (40.5%) had mild (NYHA II), 34 (11.7%) moderate (NYHA III) and 1 (0.3%) severe (NYHA IV) symptoms. Thirty four patients had an established arrhythmia, requiring treatment in 25 (8.6%). Chromosomal anomalies were identified in 10 (3.4%) and diagnostic catheterization was required in 178 (61.5%) patients. All patients underwent complete surgical correction and in 275 (95%) of them this was performed with cardiopulmonary bypass of 107+/-74 min mean duration. RESULTS: There was 1 early death (0.34%) due to embolic stroke related to atrial fibrillation (AF). Complications occurred in 50 patients (17%) and included re-operation for bleeding (5), stroke (3), pneumothorax (12), AF (22), complete heart block requiring permanent pacemaker implantation (2), wound dehiscence (1), pericardial (7) or pleural (3) effusion requiring drainage and peripheral neuropathy (1). Median intensive care unit and hospital stay was 1 (range 1-10) and 8 (range 5-42) days respectively. Two late deaths (0.7%) occurred in patients with AF and pulmonary hypertension. At mean follow-up of 45+/-24 (range 1-82) months all other patients are well with resolution or significant improvement in their symptoms. CONCLUSION: Despite the long term deleterious effects of CHD in adult patients, surgical correction can be achieved with low mortality and acceptable morbidity. All deaths and most significant complications are related to arrhythmias.
Authors:
Andrew C Chatzis; Nicolaos M Giannopoulos; Alexandros I Tsoutsinos; Grigorios Chryssostomidis; Chryssa Panagiotou; Prodromos Zavaropoulos; George Kirvasilis; George E Sarris
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē     Volume:  46     ISSN:  1109-9666     ISO Abbreviation:  -     Publication Date:    2005 Mar-Apr
Date Detail:
Created Date:  2005-04-25     Completed Date:  2005-07-05     Revised Date:  2009-02-12    
Medline Journal Info:
Nlm Unique ID:  101257381     Medline TA:  Hellenic J Cardiol     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  128-34     Citation Subset:  IM    
Affiliation:
Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece. achatzis@otenet.gr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Cardiac Surgical Procedures / methods*,  mortality
Cardiopulmonary Bypass / methods
Cohort Studies
Female
Heart Defects, Congenital / diagnosis*,  mortality,  surgery*
Humans
Male
Middle Aged
Postoperative Complications
Prognosis
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Factors
Survival Analysis
Treatment Outcome
Comments/Corrections
Comment In:
Hellenic J Cardiol. 2005 Mar-Apr;46(2):135-8   [PMID:  15847134 ]

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