Diogenes Maria Suely Bezerra, Valente Acrísio Sales, Rocha Hermano Alexandre Lima
Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil.
Department of Public Health, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
Braz J Cardiovasc Surg. 2023 Oct 6;38(6):e20230039. doi: 10.21470/1678-9741-2023-0039.
The increasing worldwide number of adults with congenital heart disease (CHD) demands greater attention from health professionals. The purpose of this report is to describe the clinical demographic profile, frequency, and invasive treatment status of adults with CHD in a public reference hospital in northeastern Brazil.
This is a retrospective cross-sectional study including 704 patients attended between August 2016 and August 2020. Data were collected from virtual database.
Patients' age varied from 17 to 81 years (mean 32±14; median 27 years); 294 (41.8%) patients were male, and 410 (58,2%) were female; 230 (32,7%) had diagnosis from age 18 and up. Cardiac complexity categories were "simple defects" (134 [19%] patients), "moderate complexity" (503 [71.5%]), and "great complexity" (67 [9.5%]). Atrial septal defect (ASD) was diagnosed in 216 (30.7%) patients, ventricular septal defect (VSD) in 101 (14.3%), tetralogy of Fallot in 93 (13.2%), and other CHD in 294 (41.8%). New York Heart Association (NYHA) functional classes were I (401 [57%]), II (203 [28.8%]), III (76 [10.8%]), and IV (24 [3.4%]). Complications were arrhythmias (173 [24%]) and severe pulmonary hypertension (69 [9.8%]). Invasive treatments were corrective surgery (364 (51.6%]), reoperation (28 [4.0%]), palliation (11 [1.6%]), interventional catheterization (12 [1.7%]), surgery plus interventional catheterization (5 [0.7%]), and preoperation (91 [12.9%]). Treatment was not required in 102 (14,5%) patients, and 91 (12.9%) were inoperable.
The leading diagnosis was ASD. Frequency of unrepaired patients was high, mainly ASD, due to late diagnosis, which favored complications and denotes a matter of great concern.
全球先天性心脏病（CHD）成年患者数量不断增加，这需要卫生专业人员给予更多关注。本报告的目的是描述巴西东北部一家公共参考医院中成年CHD患者的临床人口统计学特征、发病率及侵入性治疗情况。
这是一项回顾性横断面研究，纳入了2016年8月至2020年8月期间就诊的704例患者。数据从虚拟数据库收集。
患者年龄在17至81岁之间（平均32±14岁；中位数27岁）；男性294例（41.8%），女性410例（58.2%）；230例（32.7%）患者18岁及以上确诊。心脏复杂程度分类为“简单缺损”（134例[19%]患者）、“中度复杂”（503例[71.5%]）和“高度复杂”（67例[9.5%]）。216例（30.7%）患者诊断为房间隔缺损（ASD），101例（14.3%）为室间隔缺损（VSD），93例（13.2%）为法洛四联症，294例（41.8%）为其他CHD。纽约心脏协会（NYHA）心功能分级为I级（401例[57%]）、II级（203例[28.8%]）、III级（76例[10.8%]）和IV级（24例[3.4%]）。并发症为心律失常（173例[24%]）和重度肺动脉高压（69例[9.8%]）。侵入性治疗包括矫正手术（364例[51.6%]）、再次手术（28例[4.0%]）、姑息治疗（11例[1.6%]）、介入导管治疗（12例[1.7%]）、手术加介入导管治疗（5例[0.7%]）和术前治疗（91例[12.9%]）。102例（14.5%）患者无需治疗，91例（12.9%）患者无法手术。
主要诊断为ASD。由于诊断延迟，未修复患者的比例较高，主要是ASD，这增加了并发症的发生，值得高度关注。
