Need for palliative, corrective, and second–corrective surgery in adult patients with congenital cardiopathy classified according to disease complexity

Claudio G. Moros; Marisa Pacheco Otero; Maria Grippo; Maria del Carmen Rubio; Liliana N. Nicolosi

Volume : III, Issue : XI, November - 2014

Need for palliative, corrective, and second–corrective surgery in adult patients with congenital cardiopathy classified according to disease complexity

Claudio G. Moros, Marisa Pacheco Otero, Maria Grippo, Maria Del Carmen Rubio, Liliana N. Nicolosi

Abstract :

The prevalence of adult congenital heart disease has increased with advances in endovascular surgery and treatments. It is therefore essential to determine the need for surgery in these patients throughout their lives. Based on a multi–center database on Grown–up congenital heart disease (GUTI–GUCH), an observational study was performed to assess the need for palliative, corrective, and second–corrective surgery, in patients with adult congenital heart disease. Patients were classified as having MILD, MODERATE, or SEVERE anomalies. The association between need for surgery and severity of cardiopathy was analyzed using Kaplan Meier analysis. Study population: 714 patients; age: 32years � 11.59; females: 55.3%. Open surgery 52.8%; Closed surgery 23.9%; Palliative surgery 15.3%; Corrective surgery 57.7%; reoperation, 11.2%. Mild cardiopathy: 26%; moderate cardiopathy: 52.4%; severe cardiopathy: 21.6%. None of the patients with mild, 9% of patients with moderate, and 48% of patients with severe cardiopathy needed palliative surgery before age 10 years. Patients not requiring corrective surgery before age 10–20–30–40 years: mild cardiopathy: 90%–84%–75%–70%, moderate cardiopathy: 50%–37%–30%–27%, severe cardiopathy: 52%–34%–29%–29%. Patients not requiring reoperation before age 10–20–30–40 years: mild cardiopathy: 92%–92%–92%–92%, moderate cardiopathy: 85%–81%–77%–75% and severe cardiopathy: 85%–70%–61%–61%, respectively. Half the patients with severe and moderate cardiopathy required corrective surgery in their first decade, and 70% required corrective surgery in their third decade of life. The need for palliative and corrective reoperation was significantly higher in patients with severe congenital heart disease.