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Ann Thorac Surg 2007;83:161-168
© 2007 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Risk of Surgery for Congenital Heart Disease in the Adult: A Multicentered European Study

^a Pediatric Cardiac Surgery Unit, University of Padova, Padova, Italy
^b The Queen Silvia Children's Hospital, Goteborg, Sweden
^c Birmingham Children’s Hospital, Birmingham, United Kingdom
^d Gasthuisberg Universitair Ziekenhuis, Leuven, Belgium
^e Ospedale Pediatrico Bambino Gesu, Rome, Italy
^f Rikshospitalet, The National Hospital, Oslo, Norway
^g Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
^h Hospital de Santa Marta, Lisbon, Portugal
ⁱ The Cardiac Unit, The Great Ormond Street Hospital for Children, London, United Kingdom
^j Children’s Hospital, Bratislava, Slovakia
^k Gottsegen Gyorgy Orszagos Kardiologiai Intezet, Gyermeksziv Kozpont, Budapest, Hungary
^l Eppendorf University Hospital, Hamburg, Germany
^m The Children’s Memorial Health Institute, Warsaw, Poland
ⁿ Cliniques Universitaires Saint-Luc, Brussels, Belgium
^o Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
^p Onassis Cardiac Surgery Center, Athens, Greece
^q Deutsches Kinderherzzentrum, St. Augustin, Germany
^r Yorkshire Heart Centre, Leeds General Infirmary, Leeds, United Kingdom
^s Eberhad Karls Universitat, Tubingen, Germany

Accepted for publication July 21, 2006.

^_* Address correpondence to Dr Stellin, Department of Cardiovascular Surgery, Pediatric Cardiac Surgery Unit, Via Giustiniani, 2-35128 Padova, Italy (Email: giovanni.stellin{at}unipd.it).

BACKGROUND: Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population.

METHODS: Data relative to the hospital course of 2,012 adult patients (age 18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection.

RESULTS: Mean age at surgery was 34.4 ± 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75%), followed by reoperations (464 patients, 23.1%) and palliative procedures (39 patients, 1.9%). Six hundred forty-nine patients (32.2%) required surgical closure of an isolated ostium secundum atrial septal defect. Overall hospital mortality was 2%. Preoperative cyanosis, arrhythmias, and NYHA class III-IV, proved significant risk factors for hospital mortality. Follow-up data were available in 1,342 of 1,972 patients (68%) who were discharged home. Late deaths occurred in 6 patients (0.5%). Overall survival probability was 97% at 60 months, which is higher for corrective procedures (98.2%) if compared with reoperations (94.1%) and palliations (86.1%).

CONCLUSIONS: Surgical treatment of CHD in adult patients, in specialized cardiac units, proved quite safe, beneficial, and low-risk.

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