JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Massimo A. Padalino
Giulio Rizzoli
Giancarlo Crupi
Massimo Bernabei
Gaetano Gargiulo
Alessandro Giamberti
Francesco Santoro
Carlo Vosa
Giovanni Stellin
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Padalino, M. A.
Right arrow Articles by Stellin, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Padalino, M. A.
Right arrow Articles by Stellin, G.
Related Collections
Right arrow Congenital - cyanotic
Right arrowRelated Article

J Thorac Cardiovasc Surg 2007;134:106-113
© 2007 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Midterm results of surgical intervention for congenital heart disease in adults: An Italian multicenter study

Massimo A. Padalino, MDa, Simone Speggiorin, MDa, Giulio Rizzoli, MDa, Giancarlo Crupi, MDb, Vladimiro L. Vida, MDa, Massimo Bernabei, MDc, Gaetano Gargiulo, MDd, Alessandro Giamberti, MDe, Francesco Santoro, MDf, Carlo Vosa, MDg, Giuseppe Pacileo, MDg, Raffaele Calabrò, MDg, Luciano Daliento, MDh, Giovanni Stellin, MDa,*

a Pediatric and Congenital Cardiac Surgery Unit, Centro Gallucci, University of Padua Medical School, Padua, Italy
b Department of Cardiovascular Surgery, Ospedali Riuniti di Bergamo, Bergamo, Italy
c Department of Pediatric Cardiology, Ospedale G. Pasquinucci CREAS-CNR, Massa, Italy
d Department of Pediatric Cardiac Surgery, Azienda Ospedaliera S. Orsola-Malpighi, Bologna, Italy
e Department of Cardiac Surgery, Istituto Policlinico San Donato, Milano, Italy
f Department of Cardiac Surgery, Ospedale Niguarda Cà Granda, Milano, Italy
g Pediatric Cardiology and Cardiac Surgery, Second University, A.O. Monaldi, Naples, Italy
h Department of Cardiology, Centro Gallucci, University of Padua Medical School, Padua, Italy.

Read at the Eighty-sixth Annual Meeting of The American Association for Thoracic Surgery, Philadelphia, Pa, April 29–May 3, 2006.

Received for publication June 28, 2006; revisions received January 13, 2007; accepted for publication January 23, 2007.

* Address for reprints: Giovanni Stellin, MD, Pediatric and Congenital Cardiac Surgery Unit, Centro Gallucci, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Via Giustiniani 2 – 35128 Padova, Italy. (Email: giovanni.stellin{at}unipd.it).

Objective: We have analyzed, in a clinical multicenter study, the effect of cardiac surgery in adults with congenital heart disease in Italy.

Methods: We collected clinical data from 856 patients aged 19 years or older who underwent surgical intervention from January 1, 2000, to December 31, 2004. Patients were divided into 3 surgical groups: group 1, palliation (3.1%); group 2, repair (69.7%); and group 3, reoperation (27.4%).

Results: Preoperatively, 34.6% of patients were in New York Heart Association class I, 48.4% were in class II, 14.2% were in class III, and 2.8% were in class IV. Sinus rhythm was present in 83%. There were 1179 procedures performed in 856 patients (1.37 procedures per patient), with a hospital mortality of 3.1%. Overall mean intensive care unit stay was 2.3 days (range, 1–102 days). Major complications were reported in 247 (28.8%) patients, and postoperative arrhythmias were the most frequent. At a mean follow-up of 22 months (range, 1 month–5.5 years; completeness, 87%), late death occurred in 5 (0.5%) patients. New York Heart Association class was I in 79.3%, II in 17.6%, and III in 2.9%, and only 1 (0.11%) patient was in class IV. Overall survival estimates are 82.6%, 98.9%, and 91.8% at 5 years for groups 1, 2, and 3, respectively. Freedom from adverse events at 5 years is 91% for acyanotic patients versus 63.9% for preoperative cyanotic patients (P < .0001).

Conclusions: Surgical intervention for congenital heart disease in adults is a safe and low-risk treatment. However, patients presenting with preoperative cyanosis show a higher incidence of late adverse events and complications.

Abbreviations and Acronyms ASD = atrial septal defect; CHD = congenital heart disease; HR = hazard ratio; NYHA = New York Heart Association


Related Article

Discussion
J. Thorac. Cardiovasc. Surg. 2007 134: 113. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
A. Giamberti, M. Chessa, R. Abella, G. Butera, C. Carlucci, H. Nuri, A. Frigiola, and M. Ranucci
Morbidity and mortality risk factors in adults with congenital heart disease undergoing cardiac reoperations.
Ann. Thorac. Surg., October 1, 2009; 88(4): 1284 - 1289.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
L. M. Putman, M. van Gameren, F. J. Meijboom, P. L. de Jong, J. W. Roos-Hesselink, M. Witsenburg, J. J.M. Takkenberg, and A. J.J.C. Bogers
Seventeen years of adult congenital heart surgery: a single centre experience
Eur. J. Cardiothorac. Surg., July 1, 2009; 36(1): 96 - 104.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2007 by The American Association for Thoracic Surgery.