Skip to main content Accessibility help
×
Home
Hostname: page-component-559fc8cf4f-s65px Total loading time: 0.292 Render date: 2021-03-03T15:59:11.637Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Mid-term results following surgical treatment of congenital cardiac malformations in adults*

Published online by Cambridge University Press:  18 July 2008

Andrew C. Chatzis
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Nikolaos M. Giannopoulos
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Michael Milonakis
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Constantinos A. Contrafouris
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Alexander Tsoutsinos
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Theophilos Kolettis
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Chryssa Panagiotou
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Prodromos Zavaropoulos
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Pigi Maraki
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Theofili Koussi
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Joanne Sofianidou
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
George V. Kirvassilis
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
George E. Sarris
Affiliation:
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece
Corresponding
E-mail address:

Abstract

The long term consequences of untreated of residual or recurrent lesions pose unique challenges in the growing population of adults with congenitally malformed hearts. In our unit, 335 patients aged from 18 to 72 years, with a mean age of 35 plus or minus14 years, presented for correction of congenital cardiac disease from September, 1997, through December, 2006. Of the group, 42 (12.5%) had undergone one or more prior surgical procedures, 3 were admitted as emergencies, and a further 10 (3%) had suffered prior cardiac related complications. Symptoms had been noted by 181 patients (54%), and 42 (12.5%) had an established arrhythmia. Chromosomal anomalies were identified in 13 (3.8%), and diagnostic catheterisation was required in 201 (60%) patients. Of the overall group, 2 patients died early (0.6%). Complications occurred in 61 patients (18%), including atrial fibrillation, pneumothorax, postoperative haemorrhage, pericardial or pleural effusions requiring drainage, stroke, complete heart block, endocarditis, wound dehiscence, and peripheral neuropathy. The median length of stay in the intensive care unit and hospital were 2 and 7 days, respectively. Death occurred later in 2 further patients (0.6%), due to atrial fibrillation and pulmonary hypertension. At mean follow-up of 63 plus or minus 30 months, the majority of the remaining patients are well with resolution or significant improvement in their symptoms. Despite the long term deleterious effects of untreated, residual or recurrent congenital cardiac lesions in adults, therefore, we conclude that surgical correction can be achieved with low mortality and acceptable morbidity. Most significant complications are related to arrhythmias.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below.

Footnotes

*

The presentation on which this work is based was given at the Inaugural Meeting of the World Society for Pediatric and Congenital Heart Surgery, held in Washington, District of Columbia, May 3 and 4, 2007.

References

1. Moodie, DS. Adult congenital heart disease. Curr Opin Cardiol 1994; 9: 137142.CrossRefGoogle ScholarPubMed
2. Gatzoulis, MA. Adults with congenital heart disease: multiple needs of a fast growing cardiac patient group. Hellenic J Cardiol 2003; 44: 1015.Google Scholar
3. Perloff, JH, Warnes, CA. Challenges posed by adults with repaired congenital heart disease. Circulation 2001; 103: 26372643.CrossRefGoogle ScholarPubMed
4. Moller, JH, Anderson, RC. 1000 consecutive children with a cardiac malformation with 26- to 37-year follow-up. Am J Cardiol 1992; 70: 661667.CrossRefGoogle ScholarPubMed
5. Marelli, AJ, Mackie, AS, Ionescu-Ittu, R, Rahme, E, Pilote, L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 2007; 115: 163172.CrossRefGoogle ScholarPubMed
6. Webb, GD, Williams, RG. 32nd Bethesda conference: Care of the adult with congenital heart disease: Introduction. J Am Coll Cardiol 2001; 37: 11611169.CrossRefGoogle Scholar
7. Webb, CL, Jenkins, KJ, Karpawich, PP, et al. Collaborate care for adults with congenital heart disease. Circulation 2002; 105: 23182323.CrossRefGoogle Scholar
8. Moodie, DS. Diagnosis and management of congenital heart disease in the adult. Cardiol Rev 2001; 9: 276281.CrossRefGoogle ScholarPubMed
9. Engelfriet, P, Boersma, E, Oechslin, E, et al. The spectrum of adult congenital heart disease in Europe: morbidity and mortality in a 5 year follow-up period. The Euro Heart Survey on adult congenital heart disease. Eur Heart J 2005; 26: 23252333.CrossRefGoogle Scholar
10. Kaemmerer, H, Fratz, S, Bauer, U, et al. Emergency hospital admissions and three-year survival of adults with and without cardiovascular surgery for congenital cardiac disease. J Thorac Cardiovasc Surg 2003; 126: 10481052.CrossRefGoogle ScholarPubMed
11. Chatzis, AC, Saroglou, G, Giannopoulos, NM, Sarris, GE. Subtle infective endocarditis and congenital heart disease. Cardiol Young 2005; 15: 617620.CrossRefGoogle Scholar
12. Morris, CD, Reller, MD, Menashe, VD. Thirty-year incidence of infective endocarditis after surgery for congenital heart defect. JAMA 1998; 279: 599603.CrossRefGoogle ScholarPubMed
13. Li, W, Somerville, J. Infective endocarditis in the grown-up congenital heart (GUCH) population. Eur Heart J 1998; 19: 166173.CrossRefGoogle ScholarPubMed
14. Mott, AR, Fraser, CD Jr, McKenzie, ED, et al. Perioperative care of the adult with congenital heart disease in a free-standing tertiary pediatric facility. Pediatr Cardiol 2002; 23: 624630.CrossRefGoogle Scholar
15. Attie, F, Rosas, M, Granados, N, Zabal, C, Buendia, A, Calderon, J. Surgical treatment for secundum atrial defects in patients >40 years old. A randomized clinical trial. J Am Coll Cardiol 2002; 38: 20352042.CrossRefGoogle Scholar
16. Triedman, JK. Arrhythmias in adults with congenital heart disease. Heart 2002; 87: 383389.CrossRefGoogle ScholarPubMed
17. Kawahira, Y, Uemura, H, Yagihara, T, Yoshikawa, Y, Kitamura, S. Renewal of the Fontan circulation with concomitant surgical intervention for atrial arrhythmia. Ann Thorac Surg 2001; 71: 919921.CrossRefGoogle ScholarPubMed
18. Chatzis, A, Giannopoulos, N, Vahlas, C, et al. Surgical treatment of the atrial septal defect in adults: Effective reduction in cardiac size and excellent overall clinical outcome. Rev Port Cir Cardiotorac Vasc 2006; 13: 133137.Google ScholarPubMed
19. Brochu, MC, Baril, JF, Dore, A, Juneau, M, De Guise, P, Mercier, LA. Improvement in exercise capacity in asymptomatic and mildly symptomatic adults after atrial septal defect percutaneous closure. Circulation 2002; 106: 18211826.CrossRefGoogle ScholarPubMed
20. Chatzis, AC, Giannopoulos, NM, Vachlas, C, et al. Mitral valve status defines long term outcome after correction of partial atrioventricular septal defect. Heart Surg Forum 2006; 9 [Suppl 2]: S57.Google Scholar
21. Bol Raap, G, Meijboom, FJ, Kappetein, AP, Galema, TW, Yap, SC, Bogers, AJ. Long-term follow-up and quality of life after closure of ventricular septal defect in adults. Eur J Cardiothorac Surg 2007; 32: 215219.CrossRefGoogle ScholarPubMed
22. Rao, V, Van Arsdell, GS, David, TE, Azakie, A, Williams, WG. Aortic valve repair for adult congenital heart disease. A 22-year experience. Circulation 2000; 102 [suppl III]: III40III43.CrossRefGoogle ScholarPubMed
23. van Gameren, M, Kappetein, AP, Steyerberg, EW, et al. Do we need separate risk stratification models for hospital mortality after heart valve surgery? Ann Thorac Surg 2008; 85: 921930.CrossRefGoogle ScholarPubMed
24. Mair, DD, Puga, FJ, Danielson, GK. The Fontan procedure for tricuspid atresia: Early and late results of a 25-year experience with 216 patients. J Am Coll Cardiol 2001; 37: 933939.CrossRefGoogle ScholarPubMed
25. Mott, AR, Feltes, TF, McKenzie, ED, et al. Improved early results with the Fontan operation in adults with functional single ventricle. Ann Thorac Surg 2004; 77: 13341340.CrossRefGoogle ScholarPubMed
26. Ghavidel, AA, Javadpour, H, Tabatabaei, MB, Adambeig, A, Raeisi, K, Noohi, F. Complete surgical repair of tetralogy of Fallot in adults. Is it ever too late? J Card Surg 2008; 23: 2326.CrossRefGoogle ScholarPubMed
27. Padalino, MA, Speggiorin, S, Rizzoli, G, et al. Midterm results of surgical intervention for congenital heart disease in adults: An Italian multicenter study. J Thorac Cardiovasc Surg 2007; 134: 106113.CrossRefGoogle ScholarPubMed
28. Vida, VL, Berggren, H, Brawn, WJ, et al. Risk of surgery for congenital heart disease in the adult: A multicentered European study. Ann Thorac Surg 2007; 83: 161168.CrossRefGoogle ScholarPubMed
29. Lane, DA, Lip, GY, Millane, TA. Quality of life in adults with congenital heart disease. Heart 2002; 88: 7175.CrossRefGoogle ScholarPubMed
30. Wall, K, Oddson, H, Ternestedt, BM, Jonzon, A, Nylander, E, Schollin, J. Thirty-year electrocardiographic follow-up after repair of tetralogy of Fallot or atrial septal defect. J Electrocardiol 2007; 40: 214217.CrossRefGoogle ScholarPubMed
31. Marcelletti, CF, Hanley, FL, Mavroudis, C, et al. Revision of previous Fontan connections to total extracardiac cavopulmonary anastomosis: A multicenter experience. J Thorac Cardiovasc Surg 2000; 119: 340346.CrossRefGoogle ScholarPubMed
32. Warnes, CA, Liberthson, R, Danielson, GK Jr, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 2001; 37: 11701175.CrossRefGoogle ScholarPubMed

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 1
Total number of PDF views: 23 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 3rd March 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Mid-term results following surgical treatment of congenital cardiac malformations in adults*
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Mid-term results following surgical treatment of congenital cardiac malformations in adults*
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Mid-term results following surgical treatment of congenital cardiac malformations in adults*
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *