Adult congenital heart disease: experience with the surgical approach
OBJECTIVE: To report the institution experience with the surgical treatment of adults with congenital heart disease due to the increasing number of these patients and the need for a better discussion of the subject. METHODS: Retrospective analysis describing demographic data, risk factors and result...
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Sociedade Brasileira de Cirurgia Cardiovascular
2013-09-01
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doaj-e0d1bed5a3b246c4b92d587c11560cd42020-11-25T00:19:39ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412013-09-0128337137910.5935/1678-9741.20130057S0102-76382013000300012Adult congenital heart disease: experience with the surgical approachFernando Tadeu Vasconcelos Amaral0Alfredo José Rodrigues1Paulo Henrique Manso2André Schmidt3Maria Fernanda Kolachinski4Clovis Carbone5Ricardo Nilson Sgarbieri6Walter Vilela de Andrade Vicente7Universidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloOBJECTIVE: To report the institution experience with the surgical treatment of adults with congenital heart disease due to the increasing number of these patients and the need for a better discussion of the subject. METHODS: Retrospective analysis describing demographic data, risk factors and results. RESULTS: 191 patients between 16 and 74 years old were operated on. Primary correction was done in 171 cases, 93 (55%) for atrial septal defect repair. Among 20 (12%) reoperations, pulmonary valve replacement was done in six cases. The mean intensive care and hospital stay were 2.7 and 8.5 days respectively, significantly greater for the reoperated cases (P=0.001). The mean bypass and clamping times were 68.6 and 44.7 minutes respectively, greater for the reoperated cases (P<0.0001 and P=0.0003 respectively). Hospital mortality was 4.2% and male sex, functional class III-IV and older age at operation were predictive risk factors. Significant complications were more frequent in the reoperated cases (P<0.003), mainly atrial flutter and fibrillation. Among 183 patients discharged, 149 (82%) are being followed and atrial flutter and fibrillation are common. The mean functional class value improved significantly after operation (1.66 to 1.11; P<0.0001). The estimated survival was 96.2% in six years. CONCLUSION: Heart surgery in adults with congenital heart disease can be accomplished with low mortality and functional class improvement. Immediate and late complications are frequent. Multicenter studies are important to better characterize this patient population in the country.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300012&lng=en&tlng=enCardiopatias congênitasAdultoProcedimentos cirúrgicos cardíacos |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fernando Tadeu Vasconcelos Amaral Alfredo José Rodrigues Paulo Henrique Manso André Schmidt Maria Fernanda Kolachinski Clovis Carbone Ricardo Nilson Sgarbieri Walter Vilela de Andrade Vicente |
spellingShingle |
Fernando Tadeu Vasconcelos Amaral Alfredo José Rodrigues Paulo Henrique Manso André Schmidt Maria Fernanda Kolachinski Clovis Carbone Ricardo Nilson Sgarbieri Walter Vilela de Andrade Vicente Adult congenital heart disease: experience with the surgical approach Brazilian Journal of Cardiovascular Surgery Cardiopatias congênitas Adulto Procedimentos cirúrgicos cardíacos |
author_facet |
Fernando Tadeu Vasconcelos Amaral Alfredo José Rodrigues Paulo Henrique Manso André Schmidt Maria Fernanda Kolachinski Clovis Carbone Ricardo Nilson Sgarbieri Walter Vilela de Andrade Vicente |
author_sort |
Fernando Tadeu Vasconcelos Amaral |
title |
Adult congenital heart disease: experience with the surgical approach |
title_short |
Adult congenital heart disease: experience with the surgical approach |
title_full |
Adult congenital heart disease: experience with the surgical approach |
title_fullStr |
Adult congenital heart disease: experience with the surgical approach |
title_full_unstemmed |
Adult congenital heart disease: experience with the surgical approach |
title_sort |
adult congenital heart disease: experience with the surgical approach |
publisher |
Sociedade Brasileira de Cirurgia Cardiovascular |
series |
Brazilian Journal of Cardiovascular Surgery |
issn |
1678-9741 |
publishDate |
2013-09-01 |
description |
OBJECTIVE: To report the institution experience with the surgical treatment of adults with congenital heart disease due to the increasing number of these patients and the need for a better discussion of the subject. METHODS: Retrospective analysis describing demographic data, risk factors and results. RESULTS: 191 patients between 16 and 74 years old were operated on. Primary correction was done in 171 cases, 93 (55%) for atrial septal defect repair. Among 20 (12%) reoperations, pulmonary valve replacement was done in six cases. The mean intensive care and hospital stay were 2.7 and 8.5 days respectively, significantly greater for the reoperated cases (P=0.001). The mean bypass and clamping times were 68.6 and 44.7 minutes respectively, greater for the reoperated cases (P<0.0001 and P=0.0003 respectively). Hospital mortality was 4.2% and male sex, functional class III-IV and older age at operation were predictive risk factors. Significant complications were more frequent in the reoperated cases (P<0.003), mainly atrial flutter and fibrillation. Among 183 patients discharged, 149 (82%) are being followed and atrial flutter and fibrillation are common. The mean functional class value improved significantly after operation (1.66 to 1.11; P<0.0001). The estimated survival was 96.2% in six years. CONCLUSION: Heart surgery in adults with congenital heart disease can be accomplished with low mortality and functional class improvement. Immediate and late complications are frequent. Multicenter studies are important to better characterize this patient population in the country. |
topic |
Cardiopatias congênitas Adulto Procedimentos cirúrgicos cardíacos |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300012&lng=en&tlng=en |
work_keys_str_mv |
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