Risk of surgery for congenital heart disease in the adult: A multicentered European study

Research output: Contribution to journalArticle

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Abstract

Background. Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population. Methods. Data relative to the hospital course of 2,012 adult patients (age >= 18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection. Results. Mean age at surgery was 34.4 +/- 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75%), followed by reoperations ( 464 patients, 23.1%) and palliative procedures (39 patients, 1.9%). Six hundred forty-nine patients (32.2%) required surgical closure of an isolated ostium secundum atrial septal defect. Overall hospital mortality was 2%. Preoperative cyanosis, arrhythmias, and NYHA class III-IV, proved significant risk factors for hospital mortality. Follow-up data were available in 1,342 of 1,972 patients (68%) who were discharged home. Late deaths occurred in 6 patients (0.5%). Overall survival probability was 97% at 60 months, which is higher for corrective procedures (98.2%) if compared with reoperations (94.1%) and palliations (86.1%). Conclusions. Surgical treatment of CHD in adult patients, in specialized cardiac units, proved quite safe, beneficial, and low-risk.
Original languageUnknown
Pages (from-to)161-168
JournalAnnals of Thoracic Surgery
Volume83
Issue number1
DOIs
Publication statusPublished - 1 Jan 2007

Cite this

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title = "Risk of surgery for congenital heart disease in the adult: A multicentered European study",
abstract = "Background. Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population. Methods. Data relative to the hospital course of 2,012 adult patients (age >= 18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection. Results. Mean age at surgery was 34.4 +/- 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75{\%}), followed by reoperations ( 464 patients, 23.1{\%}) and palliative procedures (39 patients, 1.9{\%}). Six hundred forty-nine patients (32.2{\%}) required surgical closure of an isolated ostium secundum atrial septal defect. Overall hospital mortality was 2{\%}. Preoperative cyanosis, arrhythmias, and NYHA class III-IV, proved significant risk factors for hospital mortality. Follow-up data were available in 1,342 of 1,972 patients (68{\%}) who were discharged home. Late deaths occurred in 6 patients (0.5{\%}). Overall survival probability was 97{\%} at 60 months, which is higher for corrective procedures (98.2{\%}) if compared with reoperations (94.1{\%}) and palliations (86.1{\%}). Conclusions. Surgical treatment of CHD in adult patients, in specialized cardiac units, proved quite safe, beneficial, and low-risk.",
keywords = "ASSOCIATION, CARDIAC-SURGERY, STATE, OPERATIVE MORTALITY, CARE, SOCIETY, GREAT-ARTERIES, DATABASE, TRANSPOSITION, THORACIC SURGEONS",
author = "Jos{\'e} Fragata",
year = "2007",
month = "1",
day = "1",
doi = "10.1016/j.athoracsur.2006.07.045",
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Risk of surgery for congenital heart disease in the adult: A multicentered European study. / Fragata, José .

In: Annals of Thoracic Surgery, Vol. 83, No. 1, 01.01.2007, p. 161-168.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk of surgery for congenital heart disease in the adult: A multicentered European study

AU - Fragata, José

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Background. Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population. Methods. Data relative to the hospital course of 2,012 adult patients (age >= 18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection. Results. Mean age at surgery was 34.4 +/- 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75%), followed by reoperations ( 464 patients, 23.1%) and palliative procedures (39 patients, 1.9%). Six hundred forty-nine patients (32.2%) required surgical closure of an isolated ostium secundum atrial septal defect. Overall hospital mortality was 2%. Preoperative cyanosis, arrhythmias, and NYHA class III-IV, proved significant risk factors for hospital mortality. Follow-up data were available in 1,342 of 1,972 patients (68%) who were discharged home. Late deaths occurred in 6 patients (0.5%). Overall survival probability was 97% at 60 months, which is higher for corrective procedures (98.2%) if compared with reoperations (94.1%) and palliations (86.1%). Conclusions. Surgical treatment of CHD in adult patients, in specialized cardiac units, proved quite safe, beneficial, and low-risk.

AB - Background. Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population. Methods. Data relative to the hospital course of 2,012 adult patients (age >= 18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection. Results. Mean age at surgery was 34.4 +/- 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75%), followed by reoperations ( 464 patients, 23.1%) and palliative procedures (39 patients, 1.9%). Six hundred forty-nine patients (32.2%) required surgical closure of an isolated ostium secundum atrial septal defect. Overall hospital mortality was 2%. Preoperative cyanosis, arrhythmias, and NYHA class III-IV, proved significant risk factors for hospital mortality. Follow-up data were available in 1,342 of 1,972 patients (68%) who were discharged home. Late deaths occurred in 6 patients (0.5%). Overall survival probability was 97% at 60 months, which is higher for corrective procedures (98.2%) if compared with reoperations (94.1%) and palliations (86.1%). Conclusions. Surgical treatment of CHD in adult patients, in specialized cardiac units, proved quite safe, beneficial, and low-risk.

KW - ASSOCIATION

KW - CARDIAC-SURGERY

KW - STATE

KW - OPERATIVE MORTALITY

KW - CARE

KW - SOCIETY

KW - GREAT-ARTERIES

KW - DATABASE

KW - TRANSPOSITION

KW - THORACIC SURGEONS

U2 - 10.1016/j.athoracsur.2006.07.045

DO - 10.1016/j.athoracsur.2006.07.045

M3 - Article

VL - 83

SP - 161

EP - 168

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 1

ER -