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Ten-year experience with surgical treatment of adults with congenital cardiac disease

Published online by Cambridge University Press:  06 October 2010

Pierre Wauthy ,
Jacques Massaut ,
Ahmed Sanoussi ,
Hélène Demanet ,
Marielle Morissens ,
Nasroolla Damry ,
Hughes Dessy ,
Sophie G. Malekzadeh-Milani  and
Frank E. Deuvaert
Pierre Wauthy*
Affiliation:
Department of Cardiac Surgery, Brugmann University Hospital, Bruxelles, Belgium
Jacques Massaut
Affiliation:
Department of Intensive Care, Brugmann University Hospital, Bruxelles, Belgium
Ahmed Sanoussi
Affiliation:
Department of Cardiac Surgery, Brugmann University Hospital, Bruxelles, Belgium
Hélène Demanet
Affiliation:
Department of Cardiac Surgery, Brugmann University Hospital, Bruxelles, Belgium
Marielle Morissens
Affiliation:
Department of Cardiology, Brugmann University Hospital, Bruxelles, Belgium
Nasroolla Damry
Affiliation:
Department of Radiology, Brugmann University Hospital, Bruxelles, Belgium
Hughes Dessy
Affiliation:
Department of Paediatric Cardiology, University Childrens Hospital Queen Fabiola, Bruxelles, Belgium
Sophie G. Malekzadeh-Milani
Affiliation:
Department of Paediatric Cardiology, University Childrens Hospital Queen Fabiola, Bruxelles, Belgium
Frank E. Deuvaert
Affiliation:
Department of Cardiac Surgery, Brugmann University Hospital, Bruxelles, Belgium
*
Correspondence to: Pr. P. Wauthy, Service de Chirurgie Cardiaque, CHU Brugmann, 4 Place Arthur van Gehuchten, 1020 Bruxelles, Belgique. Tel: +32 2 477 39 95; Fax: +32 477 21 61; E-mail: [email protected]
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Abstract

The number of adults with congenital cardiac disease continues to increase, and adult patients are now more numerous than paediatric patients. We sought to identify risk factors for perioperative death and report our results with surgical management of adult patients with congenital cardiac disease. We retrospectively analysed in-hospital data for 244 consecutive adult patients who underwent surgical treatment of congenital cardiac disease in our centre between January, 1998 and December, 2007. The mean patient age was 27.2 plus or minus 11.9 years, 29% were in functional class III or IV, and 25% were cyanosed. Of the patients, half were operated on for the first time. A total of 61% of patients underwent curative operations, 36% a reoperation after curative treatment, and 3% a palliative operation. Overall mortality was 4.9%. Predictive factors for hospital death were functional class, cyanosis, non-sinus rhythm, a history of only palliative previous operation(s), and an indication for palliative treatment. Functional class, cyanosis, type of initial congenital cardiac disease (single ventricle and double-outlet right ventricle), and only palliative previous operation were risk factors for prolonged intensive care stay (more than 48 hours). The surgical management of adult patients with congenital cardiac disease has improved during recent decades. These generally young patients, with a complex pathology, today present a low post-operative morbidity and mortality. Patients having undergone palliative surgery and reaching adulthood without curative treatment present with an increased risk of morbidity and mortality. Univentricular hearts and double-outlet right ventricles were associated with the highest morbidity.

Keywords

Adultarrhythmiareoperationsoutcomesimaging
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 1 , February 2011 , pp. 39 - 45
Copyright
Copyright © Cambridge University Press 2010

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