Anesthetic and perioperative outcome of teenagers and adults with congenital heart disease.

OBJECTIVE

To compare the perioperative outcome of patients >or=13 years old undergoing surgery for congenital heart disease in a children's hospital by a dedicated congenital heart surgery and anesthesia team with procedure-matched younger control patients.

DESIGN

Retrospective medical record review study. From October 1997 to July 2000, medical records of all patients >12 years old requiring cardiopulmonary bypass were reviewed. A control group of patients <or=5 years old was reviewed, and 2 patients were matched to each older patient by diagnosis and surgical procedure. Data are reported as mean +/- SD. Older (study) patients were compared with younger (control) patients using t-test or chi square, with p <or= 0.05 significant.

SETTING

Medical school-affiliated tertiary-care children's hospital.

PARTICIPANTS

Patients undergoing congenital heart surgery.

MEASUREMENTS AND MAIN RESULTS

The study group (older patients) comprised 85 patients, and the control group (younger patients) comprised 170 patients. There were no intraoperative deaths. All major complications-cardiopulmonary resuscitation, neurologic injury, massive hemorrhage with sternotomy, femoral cannulation for emergent bypass, and severe episodes of hypotension on induction of anesthesia-occurred in older patients undergoing repeat sternotomy.

CONCLUSION

Mortality and major morbidity were low in both groups; however, all major intraoperative incidents occurred in older repeat sternotomy patients, suggesting increased perioperative risk for adverse outcomes in these patients.