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成人先天性心脏病患者心脏手术的结果:单中心经验

Outcome of cardiac surgery in adults with congenital heart disease: A single center experience.

作者信息

Abouelella Raja Said, Habib Eiad Ahmed, AlHalees Zohair Yousef, Alanazi Musleh Naza, Ibhais Mohamed Essa, Alwadai Abdullah Hassan

机构信息

Cardiac Surgical Intensive Care, Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaSaudi Arabia.

Alfaisal University, Riyadh, Saudi Arabia.

出版信息

J Saudi Heart Assoc. 2019 Jul;31(3):145-150. doi: 10.1016/j.jsha.2019.05.003. Epub 2019 May 18.

Abstract

OBJECTIVES

Adult survivors with congenital heart diseases represent a large and growing population, yet the published data does not represent the magnitude of their needs specifically in the Middle East. We aimed to review our experience at King Faisal Heart Center, Riyadh, Saudi Arabia for the outcome of adult patients with congenital heart disease who underwent either primary or redo surgery.

METHODS

A retrospective study at a tertiary care hospital. All patients who underwent surgery either as the first surgery or as a reoperation for congenital heart disease aged >16 years old at the time of cardiac surgery in the period between January 1, 2008 and January 1, 2013. We looked for incidence of postoperative bleeding, arrhythmias, acute kidney injury, neurological complications, duration of mechanical ventilation, hospital and intensive care unit (ICU) stay. Additionally, we assessed the mortality and 1- and 5-year survival.

RESULTS

Ninety-eight patients were included in our study. Fifty-two (53%) were females and 46 (47%) were males, with a mean age of 26 ± 8.4 years and a mean weight of 62 ± 22.8 kg. Forty-nine patients (50%) required redo surgery. Ten patients (10%) suffered from postoperative bleeding. Eight patients (8%) had postoperative arrhythmias, of which two patients required permanent pacemaker insertion. Three patients (3%) had postoperative acute kidney injury and seven patients (7%) suffered from neurological complications. The mean duration of ventilation was 1.3 ± 2 days, with a mean ICU and hospital stay of 3.7 ± 3 days, and 10 ± 7 days, respectively. The overall mortality rate in our series was 4% with a 1-5-year survival of 96%.

CONCLUSION

Adult patients with congenital heart disease are prone to immediate postoperative multisystem complications, yet the majority of them are reversible. Their 1- and 5-year survival rate is excellent. Further follow up studies are required.

摘要

目的

成年先天性心脏病幸存者数量众多且不断增加,但已发表的数据并未具体反映出中东地区他们的需求规模。我们旨在回顾沙特阿拉伯利雅得法赫德国王心脏中心对接受初次手术或再次手术的成年先天性心脏病患者的治疗结果。

方法

在一家三级护理医院进行的回顾性研究。纳入2008年1月1日至2013年1月1日期间,所有在心脏手术时年龄大于16岁、因先天性心脏病接受首次手术或再次手术的患者。我们观察术后出血、心律失常、急性肾损伤、神经并发症的发生率、机械通气时间、住院时间和重症监护病房(ICU)停留时间。此外,我们评估了死亡率以及1年和5年生存率。

结果

98例患者纳入我们的研究。52例(53%)为女性,46例(47%)为男性,平均年龄26±8.4岁,平均体重62±22.8千克。49例患者(50%)需要再次手术。10例患者(10%)术后出血。8例患者(8%)术后心律失常,其中2例患者需要植入永久性起搏器。3例患者(3%)术后发生急性肾损伤,7例患者(7%)出现神经并发症。平均通气时间为1.3±2天,平均ICU停留时间和住院时间分别为3.7±3天和10±7天。我们系列研究中的总体死亡率为4%,1至5年生存率为96%。

结论

成年先天性心脏病患者术后易发生多系统并发症,但大多数并发症是可逆的。他们的1年和5年生存率极佳。需要进一步的随访研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0633/6556753/1d0ae1db4844/gr1.jpg

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