Perinpanayagam Madurra, Larsen Signe H, Emmertsen Kristian, Møller Marianne B, Hjortdal Vibeke E
1 Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark.
2 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
World J Pediatr Congenit Heart Surg. 2017 Mar;8(2):182-188. doi: 10.1177/2150135116682454.
Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort.
Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System.
Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%).
Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.
患有先天性心脏病的成年人数量正在不断增加。我们在一个基于人群的队列中描述了手术干预、短期和长期死亡率及发病率，以及不良事件的风险因素。
纳入1994年至2012年在丹麦奥胡斯大学医院接受心脏手术的18岁及以上先天性心脏病患者。通过医院数据库、病历和丹麦民事登记系统确定诊断、手术程序、术后并发症和生存率。
对445名成年人（50%为男性）进行了474例手术。中位年龄为39岁（范围18 - 83岁）。39%的患者曾接受过手术或基于导管的干预。30天和住院死亡率为1.1%。50%的病例发生了术后并发症，大多数为轻微并发症，如临时心律失常和肺炎。主要并发症包括需要干预的术后出血（6%）、中风（2%）和急性临时肾衰竭（1%）。多因素分析确定，与1类相比，RACHS - 1分类为3类及以上（比值比（OR）= 2.3；95%置信区间（CI）：1.5 - 3.7）、纽约心脏协会功能分级III级和IV级与I级相比（OR = 2.2；95% CI：1.3 - 3.7）以及手术时年龄（OR = 1.03，95% CI：1.01 - 1.04）是不良事件的风险因素。中位随访7.8年（范围0天 - 21.4年）期间的生存率为85%（95% CI：80% - 89%）。
患有先天性心脏病的成年人数量不断增加，需要进行心脏手术。术后并发症常见，但早期和晚期死亡率较低。
