Midterm results of surgical intervention for congenital heart disease in adults

An Italian multicenter study

Massimo A. Padalino, Simone Speggiorin, Giulio Rizzoli, Giancarlo Crupi, Vladimiro L. Vida, Massimo Bernabei, Gaetano Gargiulo, Alessandro Giamberti, Francesco Santoro, Carlo Vosa, Giuseppe Pacileo, Raffaele Calabrò, Luciano Daliento, Giovanni Stellin

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: We have analyzed, in a clinical multicenter study, the effect of cardiac surgery in adults with congenital heart disease in Italy. Methods: We collected clinical data from 856 patients aged 19 years or older who underwent surgical intervention from January 1, 2000, to December 31, 2004. Patients were divided into 3 surgical groups: group 1, palliation (3.1%); group 2, repair (69.7%); and group 3, reoperation (27.4%). Results: Preoperatively, 34.6% of patients were in New York Heart Association class I, 48.4% were in class II, 14.2% were in class III, and 2.8% were in class IV. Sinus rhythm was present in 83%. There were 1179 procedures performed in 856 patients (1.37 procedures per patient), with a hospital mortality of 3.1%. Overall mean intensive care unit stay was 2.3 days (range, 1-102 days). Major complications were reported in 247 (28.8%) patients, and postoperative arrhythmias were the most frequent. At a mean follow-up of 22 months (range, 1 month-5.5 years; completeness, 87%), late death occurred in 5 (0.5%) patients. New York Heart Association class was I in 79.3%, II in 17.6%, and III in 2.9%, and only 1 (0.11%) patient was in class IV. Overall survival estimates are 82.6%, 98.9%, and 91.8% at 5 years for groups 1, 2, and 3, respectively. Freedom from adverse events at 5 years is 91% for acyanotic patients versus 63.9% for preoperative cyanotic patients (P <.0001). Conclusions: Surgical intervention for congenital heart disease in adults is a safe and low-risk treatment. However, patients presenting with preoperative cyanosis show a higher incidence of late adverse events and complications.

Original languageEnglish
JournalJournal of Thoracic and Cardiovascular Surgery
Volume134
Issue number1
DOIs
Publication statusPublished - Jul 2007

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Multicenter Studies
Heart Diseases
Cyanosis
Hospital Mortality
Reoperation
Italy
Thoracic Surgery
Intensive Care Units
Cardiac Arrhythmias
Survival
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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Midterm results of surgical intervention for congenital heart disease in adults : An Italian multicenter study. / Padalino, Massimo A.; Speggiorin, Simone; Rizzoli, Giulio; Crupi, Giancarlo; Vida, Vladimiro L.; Bernabei, Massimo; Gargiulo, Gaetano; Giamberti, Alessandro; Santoro, Francesco; Vosa, Carlo; Pacileo, Giuseppe; Calabrò, Raffaele; Daliento, Luciano; Stellin, Giovanni.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 134, No. 1, 07.2007.

Research output: Contribution to journalArticle

Padalino, MA, Speggiorin, S, Rizzoli, G, Crupi, G, Vida, VL, Bernabei, M, Gargiulo, G, Giamberti, A, Santoro, F, Vosa, C, Pacileo, G, Calabrò, R, Daliento, L & Stellin, G 2007, 'Midterm results of surgical intervention for congenital heart disease in adults: An Italian multicenter study', Journal of Thoracic and Cardiovascular Surgery, vol. 134, no. 1. https://doi.org/10.1016/j.jtcvs.2007.01.080
Padalino, Massimo A. ; Speggiorin, Simone ; Rizzoli, Giulio ; Crupi, Giancarlo ; Vida, Vladimiro L. ; Bernabei, Massimo ; Gargiulo, Gaetano ; Giamberti, Alessandro ; Santoro, Francesco ; Vosa, Carlo ; Pacileo, Giuseppe ; Calabrò, Raffaele ; Daliento, Luciano ; Stellin, Giovanni. / Midterm results of surgical intervention for congenital heart disease in adults : An Italian multicenter study. In: Journal of Thoracic and Cardiovascular Surgery. 2007 ; Vol. 134, No. 1.
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abstract = "Objective: We have analyzed, in a clinical multicenter study, the effect of cardiac surgery in adults with congenital heart disease in Italy. Methods: We collected clinical data from 856 patients aged 19 years or older who underwent surgical intervention from January 1, 2000, to December 31, 2004. Patients were divided into 3 surgical groups: group 1, palliation (3.1{\%}); group 2, repair (69.7{\%}); and group 3, reoperation (27.4{\%}). Results: Preoperatively, 34.6{\%} of patients were in New York Heart Association class I, 48.4{\%} were in class II, 14.2{\%} were in class III, and 2.8{\%} were in class IV. Sinus rhythm was present in 83{\%}. There were 1179 procedures performed in 856 patients (1.37 procedures per patient), with a hospital mortality of 3.1{\%}. Overall mean intensive care unit stay was 2.3 days (range, 1-102 days). Major complications were reported in 247 (28.8{\%}) patients, and postoperative arrhythmias were the most frequent. At a mean follow-up of 22 months (range, 1 month-5.5 years; completeness, 87{\%}), late death occurred in 5 (0.5{\%}) patients. New York Heart Association class was I in 79.3{\%}, II in 17.6{\%}, and III in 2.9{\%}, and only 1 (0.11{\%}) patient was in class IV. Overall survival estimates are 82.6{\%}, 98.9{\%}, and 91.8{\%} at 5 years for groups 1, 2, and 3, respectively. Freedom from adverse events at 5 years is 91{\%} for acyanotic patients versus 63.9{\%} for preoperative cyanotic patients (P <.0001). Conclusions: Surgical intervention for congenital heart disease in adults is a safe and low-risk treatment. However, patients presenting with preoperative cyanosis show a higher incidence of late adverse events and complications.",
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AU - Padalino, Massimo A.

AU - Speggiorin, Simone

AU - Rizzoli, Giulio

AU - Crupi, Giancarlo

AU - Vida, Vladimiro L.

AU - Bernabei, Massimo

AU - Gargiulo, Gaetano

AU - Giamberti, Alessandro

AU - Santoro, Francesco

AU - Vosa, Carlo

AU - Pacileo, Giuseppe

AU - Calabrò, Raffaele

AU - Daliento, Luciano

AU - Stellin, Giovanni

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N2 - Objective: We have analyzed, in a clinical multicenter study, the effect of cardiac surgery in adults with congenital heart disease in Italy. Methods: We collected clinical data from 856 patients aged 19 years or older who underwent surgical intervention from January 1, 2000, to December 31, 2004. Patients were divided into 3 surgical groups: group 1, palliation (3.1%); group 2, repair (69.7%); and group 3, reoperation (27.4%). Results: Preoperatively, 34.6% of patients were in New York Heart Association class I, 48.4% were in class II, 14.2% were in class III, and 2.8% were in class IV. Sinus rhythm was present in 83%. There were 1179 procedures performed in 856 patients (1.37 procedures per patient), with a hospital mortality of 3.1%. Overall mean intensive care unit stay was 2.3 days (range, 1-102 days). Major complications were reported in 247 (28.8%) patients, and postoperative arrhythmias were the most frequent. At a mean follow-up of 22 months (range, 1 month-5.5 years; completeness, 87%), late death occurred in 5 (0.5%) patients. New York Heart Association class was I in 79.3%, II in 17.6%, and III in 2.9%, and only 1 (0.11%) patient was in class IV. Overall survival estimates are 82.6%, 98.9%, and 91.8% at 5 years for groups 1, 2, and 3, respectively. Freedom from adverse events at 5 years is 91% for acyanotic patients versus 63.9% for preoperative cyanotic patients (P <.0001). Conclusions: Surgical intervention for congenital heart disease in adults is a safe and low-risk treatment. However, patients presenting with preoperative cyanosis show a higher incidence of late adverse events and complications.

AB - Objective: We have analyzed, in a clinical multicenter study, the effect of cardiac surgery in adults with congenital heart disease in Italy. Methods: We collected clinical data from 856 patients aged 19 years or older who underwent surgical intervention from January 1, 2000, to December 31, 2004. Patients were divided into 3 surgical groups: group 1, palliation (3.1%); group 2, repair (69.7%); and group 3, reoperation (27.4%). Results: Preoperatively, 34.6% of patients were in New York Heart Association class I, 48.4% were in class II, 14.2% were in class III, and 2.8% were in class IV. Sinus rhythm was present in 83%. There were 1179 procedures performed in 856 patients (1.37 procedures per patient), with a hospital mortality of 3.1%. Overall mean intensive care unit stay was 2.3 days (range, 1-102 days). Major complications were reported in 247 (28.8%) patients, and postoperative arrhythmias were the most frequent. At a mean follow-up of 22 months (range, 1 month-5.5 years; completeness, 87%), late death occurred in 5 (0.5%) patients. New York Heart Association class was I in 79.3%, II in 17.6%, and III in 2.9%, and only 1 (0.11%) patient was in class IV. Overall survival estimates are 82.6%, 98.9%, and 91.8% at 5 years for groups 1, 2, and 3, respectively. Freedom from adverse events at 5 years is 91% for acyanotic patients versus 63.9% for preoperative cyanotic patients (P <.0001). Conclusions: Surgical intervention for congenital heart disease in adults is a safe and low-risk treatment. However, patients presenting with preoperative cyanosis show a higher incidence of late adverse events and complications.

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