[Six-year experience with cardiac surgery in adults with congenital heart disease].

Autor:	Popelová J; Oddelení kardiochirurgie, Kardiocentrum Nemocnice Na Homolce, Praha. jana.popelova@homolka.cz, Cerný S, Gebauer R, Pavel P, Jehlicka P
Jazyk:	čeština
Zdroj:	Casopis lekaru ceskych [Cas Lek Cesk] 2011; Vol. 150 (4-5), pp. 293-6.
Abstrakt:	Background: Increasing number of adults with congenital heart disease (ACHD) require reoperation or primary repair. To define risk and outcome of operations of ACHD performed in adult cardiac surgery. Methods: Between 2005-2010 we operated on 459 patients with ACHD, aged 40.4 +/- 15 years. Operations of ACHD represented 9.5% of 4854 cardiac operations in our department. Results: The 30-days mortality was 1.1%, hospital mortality was 1.52%, long-term mortality among discharged patients was 1.3%. Reoperations after surgery in childhood represented 39%, repeated reoperations 9%, operations of 3 or 4 valves 2.6%. Robotic surgery or minithoracotomy was performed in 9%. Pulmonary hypertension was present in 11.3%, NYHA III-IV in 30%. The risk factors of mortality were: NYHA class III-IV (p < 0.001), cyanosis (p < 0.001), severe systolic dysfunction of left (p = 0.006) or right ventricle (p < 0.001).We did not confirm increased risk in older patients, women, pulmonary hypertension, reoperations and operations of 3-4 valves. Conclusions: Excellent surgical results among older adults with CHD were achieved by the co-operation of paediatric cardiac surgeon within the experienced centre for adult cardiac surgery. The highest risk was found in patients with NYHA class Ill-IV, cyanosis and ventricular dysfunction.
Databáze:	MEDLINE
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