Clinical Characteristics and Outcomes in Adults With Moderate-to-Severe Complexity Congenital Heart Disease Undergoing Palliation or Surgical Repair.

Autor:	García-Cruz E; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Manzur-Sandoval D; Cardiovascular Critical Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Gopar-Nieto R; Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Angulo-Cruzado ST; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Sánchez-López SV; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Torres-Martel JM; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Ramírez-Marroquín S; Congenital Heart Disease Surgery Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Cervantes-Salazar JL; Congenital Heart Disease Surgery Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Benita-Bordes A; Congenital Heart Disease Surgery Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Calderon-Colmenero J; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., García-Montes JA; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Díaz-Gallardo LG; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Montalvo-Ocotoxtle IG; Education Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Escobar-Sibaja LE; Education Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Sánchez-Rodríguez CC; Education Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Barajas-Campos RL; Hospitalization Service, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., García-Cruz JC; CONACYT/Universidad Autónoma Metropolitana Unidad Xochimilco, Mexico City, Mexico., Villalobos-Pedroza M; Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Sánchez-Nieto J; Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Mier Y Terán-Morales E; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Navarro-Martínez DA; Congenital Heart Disease Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico., Baranda-Tovar FM; Surgical and Medical Specialties Direction, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Jazyk:	angličtina
Zdroj:	CJC pediatric and congenital heart disease [CJC Pediatr Congenit Heart Dis] 2022 Oct 21; Vol. 2 (2), pp. 63-73. Date of Electronic Publication: 2022 Oct 21 (Print Publication: 2023).
DOI:	10.1016/j.cjcpc.2022.10.005
Abstrakt:	Background: Congenital heart disease (CHD) survival rate has improved dramatically due to advances in diagnostic and therapeutic techniques. However, concerning the unrepaired CHD population of moderate and severe complexity, the data regarding risk predictors and surgical outcomes are scarce. Our aim was to describe the surgical results and predictors of in-hospital outcomes in adult patients with moderate-to-severe complexity CHD that were not repaired in childhood. Methods: We conducted a retrospective cohort study that included 49 adult patients with moderate-to-complex CHD who were treated in a single medical centre. Clinical and echocardiographic variables were obtained on admission, after surgical procedures and during follow-up. Results: Most of the patients were female (66%). Left ventricular ejection fraction and right ventricular outflow tract fractional shortening were within the normal range. The median pulmonary artery systolic pressure was 37 (27-55) mm Hg. The median time was 118 (80-181) minutes for extracorporeal circulation and 76 (49-121) minutes for aortic cross-clamping. The most frequent complication was postoperative complete atrioventricular block (12.2%). In-hospital survival rate was 87.7%. The development of low cardiac output syndrome with predominant right ventricle failure in the postoperative period was the most important predictor of in-hospital death ( P  = 0.03). Conclusions: Deciding to treat adults with CHD is challenging in moderate and severe unrepaired cases. Adequate clinical, functional, and imaging evaluation is essential to determine each patient's suitability for surgical management and to achieve the best clinical outcome for this population. (© 2022 The Author(s).)
Databáze:	MEDLINE
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