Cardiac surgery in adults with high-surgical complexity CHD: Results of a network collaborative programme

Vered Gilad, Francesco Santoro, Elena Ribera, Maria G. Calevo, Adriano Cipriani, Achille Pasquè, Sergio L. Chierchia

Research output: Contribution to journalArticlepeer-review

Abstract

Background Adults with CHD often exhibit complex cardiac abnormalities, whose management requires specific clinical and surgical expertise. To enable easier access of these patients to highly specialised care, we implemented a collaborative programme that incorporates medical and surgical specialists belonging to both paediatric and adult cardiovascular institutions. Objectives The objective of this study was to review the experience gained and to analyse the surgical outcome of major cardiac surgery. Methods We retrospectively reviewed all consecutive patients admitted for major cardiac surgery using our network between January, 2010 and December, 2013. Analysis of surgical outcome was performed in patients selected for major cardiac surgery with cardiopulmonary bypass. Early and late outcomes were evaluated. Results Out of a total of 433 inward patients, 86 were selected for surgery. The median age was 25.5 years, -64 patients (74.4%) had previously undergone heart surgery, and -55 patients (64%) had been subjected to at least one sternotomy. Abnormalities of the left ventricular and right ventricular outflow tract were the most frequent (37.2% and 30.2%, respectively), and despite high-surgical complexity only one death occurred (in-hospital mortality 1.1%). On a median follow-up time of 4 years no deaths and no heart-failure events have occurred; one patient underwent further cardiac surgery programmed at the time of discharge. Conclusions Low mortality and morbidity rates can be obtained in high-surgical complexity adults with CHD populations when paediatric and adult cardiac specialists operate in the same multidisciplinary environment.

Original languageEnglish
Pages (from-to)101-107
Number of pages7
JournalCardiology in the Young
Volume28
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Adult
  • cardiac surgery
  • CHD
  • organisation model

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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