HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

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

^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.

Related Article

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