Cor Vasa 2007, 49(5):169-173 | DOI: 10.33678/cor.2007.064

Our experience with a systematic program of care of adults with congenital heart disease

Jana Popelová¹, Štěpán Černý¹, Roman Gebauer⁴, Petr Pavel¹, Pavel Jehlička¹, Petr Kolouch¹, David Doubek¹, Petr Kmoníček², Petr Neužil², Miloš Táborský², Petr Niederle², Jiří Weichet³, Bohumil Hučín⁴, Jan Škovránek⁴, Petr Tax⁴, Oleg Reich⁴, Roman A. Gebauer⁴

¹ Oddělení kardiochirurgie, Nemocnice Na Homolce

² Oddělení kardiologie

³ Oddělení zobrazovacích metod, Nemocnice Na Homolce

⁴ Dětské kardiocentrum, Fakultní nemocnice Motol a Centrum výzkumu chorob srdce a cév, Praha, Česká republika

Aim:
A retrospective evaluation of the outcomes of a program of systematic care of adults with congenital heart disease (CHD) at Na Homolce Hospital.


Patients:
Out of more than 1,900 adults with congenital heart disease, 128 were operated on from April 2005 through January 2007. The mean age was 41 ± 15 years.

Results:
Surgical mortality was zero as was 30-day mortality; 3 patients were lost to long-term follow-up. The average hospitalization time was 11.7 ± 5 days. Reoperations accounted for 46% of all operations, 15% were repeat reoperations. Total cavopulmonary connection (TCPC) as the first surgical procedure in the adult age was undertaken in two cases,
reoperations of complex CHD were performed in seven cases (reoperation after TCPC, reoperation after Senning, Mustard or Rastelli correction). Besides surgical antiarrhythmic procedures, we performed 17 successful transcatheter radiofrequency ablation procedures and nine ICD implantations. Post-procedural NYHA class improved significantly, from 2.3 ± 0.7 to 1.3 ± 0.2; p < 0.001.

Conclusion:
Operations and reoperations of CHD can be performed in adults with excellent outcomes, low mortality and morbidity rates, and short hospitalization times in settings providing comprehensive care and teamwork. A condition sine qua non is a large body of experience, hence centralization of cardiac surgical care of CHD in adults is warranted.

Keywords: Congenital heart disease; Adults; Cardiac surgery; Reoperations; Arrhythmias

Published: May 1, 2007  Show citation