Adult congenital heart disease: experience with the surgical approach

Detalhes bibliográficos
Autor(a) principal: Amaral,Fernando Tadeu Vasconcelos
Data de Publicação: 2013
Outros Autores: Rodrigues,Alfredo José, Manso,Paulo Henrique, Schmidt,André, Kolachinski,Maria Fernanda, Carbone,Clovis, Sgarbieri,Ricardo Nilson, Vicente,Walter Vilela de Andrade
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Cardiovascular Surgery (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300012
Resumo: OBJECTIVE: To report the institution experience with the surgical treatment of adults with congenital heart disease due to the increasing number of these patients and the need for a better discussion of the subject. METHODS: Retrospective analysis describing demographic data, risk factors and results. RESULTS: 191 patients between 16 and 74 years old were operated on. Primary correction was done in 171 cases, 93 (55%) for atrial septal defect repair. Among 20 (12%) reoperations, pulmonary valve replacement was done in six cases. The mean intensive care and hospital stay were 2.7 and 8.5 days respectively, significantly greater for the reoperated cases (P=0.001). The mean bypass and clamping times were 68.6 and 44.7 minutes respectively, greater for the reoperated cases (P<0.0001 and P=0.0003 respectively). Hospital mortality was 4.2% and male sex, functional class III-IV and older age at operation were predictive risk factors. Significant complications were more frequent in the reoperated cases (P<0.003), mainly atrial flutter and fibrillation. Among 183 patients discharged, 149 (82%) are being followed and atrial flutter and fibrillation are common. The mean functional class value improved significantly after operation (1.66 to 1.11; P<0.0001). The estimated survival was 96.2% in six years. CONCLUSION: Heart surgery in adults with congenital heart disease can be accomplished with low mortality and functional class improvement. Immediate and late complications are frequent. Multicenter studies are important to better characterize this patient population in the country.
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spelling Adult congenital heart disease: experience with the surgical approachHeart defects, congenitalAdultCardiac surgical proceduresOBJECTIVE: To report the institution experience with the surgical treatment of adults with congenital heart disease due to the increasing number of these patients and the need for a better discussion of the subject. METHODS: Retrospective analysis describing demographic data, risk factors and results. RESULTS: 191 patients between 16 and 74 years old were operated on. Primary correction was done in 171 cases, 93 (55%) for atrial septal defect repair. Among 20 (12%) reoperations, pulmonary valve replacement was done in six cases. The mean intensive care and hospital stay were 2.7 and 8.5 days respectively, significantly greater for the reoperated cases (P=0.001). The mean bypass and clamping times were 68.6 and 44.7 minutes respectively, greater for the reoperated cases (P<0.0001 and P=0.0003 respectively). Hospital mortality was 4.2% and male sex, functional class III-IV and older age at operation were predictive risk factors. Significant complications were more frequent in the reoperated cases (P<0.003), mainly atrial flutter and fibrillation. Among 183 patients discharged, 149 (82%) are being followed and atrial flutter and fibrillation are common. The mean functional class value improved significantly after operation (1.66 to 1.11; P<0.0001). The estimated survival was 96.2% in six years. CONCLUSION: Heart surgery in adults with congenital heart disease can be accomplished with low mortality and functional class improvement. Immediate and late complications are frequent. Multicenter studies are important to better characterize this patient population in the country.Sociedade Brasileira de Cirurgia Cardiovascular2013-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300012Brazilian Journal of Cardiovascular Surgery v.28 n.3 2013reponame:Brazilian Journal of Cardiovascular Surgery (Online)instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)instacron:SBCCV10.5935/1678-9741.20130057info:eu-repo/semantics/openAccessAmaral,Fernando Tadeu VasconcelosRodrigues,Alfredo JoséManso,Paulo HenriqueSchmidt,AndréKolachinski,Maria FernandaCarbone,ClovisSgarbieri,Ricardo NilsonVicente,Walter Vilela de Andradeeng2013-12-16T00:00:00Zoai:scielo:S0102-76382013000300012Revistahttp://www.rbccv.org.br/https://old.scielo.br/oai/scielo-oai.php||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br1678-97410102-7638opendoar:2013-12-16T00:00Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)false
dc.title.none.fl_str_mv Adult congenital heart disease: experience with the surgical approach
title Adult congenital heart disease: experience with the surgical approach
spellingShingle Adult congenital heart disease: experience with the surgical approach
Amaral,Fernando Tadeu Vasconcelos
Heart defects, congenital
Adult
Cardiac surgical procedures
title_short Adult congenital heart disease: experience with the surgical approach
title_full Adult congenital heart disease: experience with the surgical approach
title_fullStr Adult congenital heart disease: experience with the surgical approach
title_full_unstemmed Adult congenital heart disease: experience with the surgical approach
title_sort Adult congenital heart disease: experience with the surgical approach
author Amaral,Fernando Tadeu Vasconcelos
author_facet Amaral,Fernando Tadeu Vasconcelos
Rodrigues,Alfredo José
Manso,Paulo Henrique
Schmidt,André
Kolachinski,Maria Fernanda
Carbone,Clovis
Sgarbieri,Ricardo Nilson
Vicente,Walter Vilela de Andrade
author_role author
author2 Rodrigues,Alfredo José
Manso,Paulo Henrique
Schmidt,André
Kolachinski,Maria Fernanda
Carbone,Clovis
Sgarbieri,Ricardo Nilson
Vicente,Walter Vilela de Andrade
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Amaral,Fernando Tadeu Vasconcelos
Rodrigues,Alfredo José
Manso,Paulo Henrique
Schmidt,André
Kolachinski,Maria Fernanda
Carbone,Clovis
Sgarbieri,Ricardo Nilson
Vicente,Walter Vilela de Andrade
dc.subject.por.fl_str_mv Heart defects, congenital
Adult
Cardiac surgical procedures
topic Heart defects, congenital
Adult
Cardiac surgical procedures
description OBJECTIVE: To report the institution experience with the surgical treatment of adults with congenital heart disease due to the increasing number of these patients and the need for a better discussion of the subject. METHODS: Retrospective analysis describing demographic data, risk factors and results. RESULTS: 191 patients between 16 and 74 years old were operated on. Primary correction was done in 171 cases, 93 (55%) for atrial septal defect repair. Among 20 (12%) reoperations, pulmonary valve replacement was done in six cases. The mean intensive care and hospital stay were 2.7 and 8.5 days respectively, significantly greater for the reoperated cases (P=0.001). The mean bypass and clamping times were 68.6 and 44.7 minutes respectively, greater for the reoperated cases (P<0.0001 and P=0.0003 respectively). Hospital mortality was 4.2% and male sex, functional class III-IV and older age at operation were predictive risk factors. Significant complications were more frequent in the reoperated cases (P<0.003), mainly atrial flutter and fibrillation. Among 183 patients discharged, 149 (82%) are being followed and atrial flutter and fibrillation are common. The mean functional class value improved significantly after operation (1.66 to 1.11; P<0.0001). The estimated survival was 96.2% in six years. CONCLUSION: Heart surgery in adults with congenital heart disease can be accomplished with low mortality and functional class improvement. Immediate and late complications are frequent. Multicenter studies are important to better characterize this patient population in the country.
publishDate 2013
dc.date.none.fl_str_mv 2013-09-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300012
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300012
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/1678-9741.20130057
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
dc.source.none.fl_str_mv Brazilian Journal of Cardiovascular Surgery v.28 n.3 2013
reponame:Brazilian Journal of Cardiovascular Surgery (Online)
instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron:SBCCV
instname_str Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron_str SBCCV
institution SBCCV
reponame_str Brazilian Journal of Cardiovascular Surgery (Online)
collection Brazilian Journal of Cardiovascular Surgery (Online)
repository.name.fl_str_mv Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
repository.mail.fl_str_mv ||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br
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