Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Louisville, Louisville, KY, USA.
J Thorac Cardiovasc Surg. 2011 Nov;142(5):1090-7. doi: 10.1016/j.jtcvs.2011.07.028. Epub 2011 Sep 10.
Outcomes data for adults undergoing congenital heart surgery are limited. Previous analyses used administrative data or focused on single-center outcomes. We describe the most common operations, patient characteristics, and postoperative outcomes using a multicenter clinical database.
The study included adults (aged ≥ 18 years) listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2000-2009). We describe patient characteristics and morbidity and mortality, and examine congenital procedures in the Society of Thoracic Surgeons Adult Cardiac Surgery Database to permit consideration of the primary dataset within a broader context.
A total of 5265 patients (68 centers) from the Society of Thoracic Surgeons Congenital Heart Surgery Database were included. Patients' median age was 25 years (interquartile range, 20-35). Common preoperative risk factors included noncardiac abnormalities (17%) and arrhythmia (14%). Overall, in-hospital mortality was 2.1%, 27% had 1 or more complication, and median length of stay was 5 days. Common operations included right ventricular outflow tract procedures (21%) and pacemaker/arrhythmia procedures (20%). We further evaluated cardiopulmonary bypass procedures in more than 100 patients. Mortality ranged from 0% (atrial septal defect repair) to 11% (Fontan revision/conversion). Separate evaluation of the Society of Thoracic Surgeons Adult Cardiac Surgery Database revealed 39,872 adults undergoing congenital heart operations.
Most adult congenital heart operations listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database are performed in the third to fourth decades of life; approximately half are for right heart pathology or arrhythmia. Many patients have complications, but mortality is low with the exception of those undergoing Fontan revision/conversion. Many more adults undergoing congenital heart surgery are entered into the Society of Thoracic Surgeons Adult Cardiac Surgery Database.
成人先天性心脏病手术的结果数据有限。先前的分析使用行政数据或侧重于单中心的结果。我们使用多中心临床数据库描述最常见的手术、患者特征和术后结果。
该研究纳入了 2000-2009 年在胸外科医师学会先天性心脏病手术数据库中列出的成人（年龄≥18 岁）。我们描述了患者特征和发病率及死亡率，并在胸外科医师学会成人心脏手术数据库中检查了先天性手术，以便在更广泛的背景下考虑主要数据集。
来自胸外科医师学会先天性心脏病手术数据库的共有 5265 例患者（68 个中心）纳入本研究。患者的中位年龄为 25 岁（四分位间距 20-35）。常见的术前危险因素包括非心脏异常（17%）和心律失常（14%）。总体而言，院内死亡率为 2.1%，27%的患者发生 1 种或多种并发症，中位住院时间为 5 天。常见的手术包括右心室流出道手术（21%）和起搏器/心律失常手术（20%）。我们进一步评估了 100 多例体外循环手术。死亡率范围从 0%（房间隔缺损修补术）到 11%（Fontan 修正/转换术）。对胸外科医师学会成人心脏手术数据库的单独评估显示，有 39872 例成人接受了先天性心脏病手术。
胸外科医师学会先天性心脏病手术数据库中列出的大多数成人先天性心脏病手术是在第三至第四个十年进行的；大约一半是用于右心病变或心律失常。许多患者有并发症，但死亡率低，除了接受 Fontan 修正/转换术的患者外。有更多的成人接受先天性心脏病手术被收入胸外科医师学会成人心脏手术数据库。
