Aasim Muhammad, Aziz Raheela, Mohsin Atta Ul, Khan Raheel, Zahid Ayesha, Ikram Jibran
Cardiac Surgery, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Cardiovascular Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Cureus. 2024 Nov 28;16(11):e74688. doi: 10.7759/cureus.74688. eCollection 2024 Nov.
Background With the rising number of children with congenital heart disease (CHD) reaching adulthood, surgical intervention has become a critical aspect of their long-term management. This study presents a six-year overview of early postoperative outcomes and mortality in CHD surgeries at a single center, underscoring advancements and challenges in treating this complex population. Objective As more children with CHD grow into adulthood, we are gaining critical insights from our extensive experience in performing cardiac surgery for this population. This report details our six-year experience at a single center, highlighting short-term outcomes and in-hospital mortality rates. Methods We collected data on all consecutive patients with CHD who underwent surgery between July 2018 and September 2024 in the Cardiac Surgery Department at Hayatabad Medical Complex, Peshawar, Pakistan. We evaluated early outcomes, including ventilation duration, length of intensive care unit (ICU) stay, total hospital stay, and mortality rates. Results A total of 250 procedures were performed on patients, with a mean age of 22.98 years (Range 1-78 years); 48.4% were male and 51.6% were female. Re-do procedures accounted for 2.4% of the total procedures. The most common procedures involved repair of septal defects (43.8%), right heart lesions (19.2%), and thoracic arterial and venous surgeries (16.8%). While the primary procedures involved less complex cases, they included 15.2% tetralogy of Fallot repairs, 4.0% aortic coarctation repairs, and 1.2% repairs for Ebstein's disease. In-hospital mortality was recorded at 1.6%, with an overall survival rate of 98.4%. Conclusion Surgery in patients with CHD can be performed with low operative mortality and favorable clinical outcomes. Our findings demonstrate that, despite the complexities inherent to this population, most procedures yield successful results, contributing to a high overall survival rate. This underscores the importance of specialized surgical approaches and continuous management for CHD patients, emphasizing the potential for positive long-term outcomes in this growing demographic.
背景 随着患有先天性心脏病(CHD)的儿童成年人数的增加,手术干预已成为他们长期管理的关键方面。本研究呈现了一个单一中心CHD手术术后早期结果和死亡率的六年概述,强调了治疗这一复杂人群的进展和挑战。
目的 随着越来越多的CHD儿童成长为成年人,我们从为这一人群进行心脏手术的丰富经验中获得了重要见解。本报告详细介绍了我们在一个单一中心的六年经验,突出了短期结果和住院死亡率。
方法 我们收集了2018年7月至2024年9月期间在巴基斯坦白沙瓦哈亚塔巴德医疗中心心脏外科接受手术的所有连续性CHD患者的数据。我们评估了早期结果,包括通气时间、重症监护病房(ICU)住院时间、总住院时间和死亡率。
结果 共对患者进行了250例手术,平均年龄为22.98岁(范围1 - 78岁);48.4%为男性,51.6%为女性。再次手术占总手术的2.4%。最常见的手术包括室间隔缺损修复(43.8%)、右心病变修复(19.2%)和胸主动脉和静脉手术(16.8%)。虽然初次手术涉及的病例不太复杂,但包括15.2%的法洛四联症修复、4.0%的主动脉缩窄修复和1.2%的埃布斯坦畸形修复。住院死亡率为1.6%,总生存率为98.4%。
结论 CHD患者手术的手术死亡率低,临床结果良好。我们的研究结果表明,尽管这一人群存在固有复杂性,但大多数手术都能取得成功结果,从而导致较高的总生存率。这强调了针对CHD患者的专业手术方法和持续管理的重要性,突出了在这一不断增长的人群中取得积极长期结果的潜力。