What about congenital heart diseases operated in adults? A case series of 130 patients

Abstract

Introduction

Congenital heart disease is the most common congenital malformation and affects nearly 1% of births. Surgery for congenital heart disease in adults has special characteristics that differentiate it from congenital heart surgery in children and heart surgery for acquired diseases in adults: the diversity of the anatomoclinical situations and the difficulty of the specific surgical techniques are the most important. The presence of multiorgan involvement is common in these patients, which complicates anesthesia and the postoperative period.

Objective

The main objective of our work was to evaluate the immediate and 6-month results of congenital heart diseases surgery in adulthood in terms of feasibility, morbidity and mortality.

Methods

It was a retrospective descriptive study conducted in the Cardiovascular Surgery Department of La Rabta Hospital over a 10 year period. We included patients who underwent surgical correction in adulthood (≥ 18 years). We excluded patients who files were not usable or who were lost to follow-up. We recruited 130 patients with congenital heart disease diagnoses on echocardiography and operated on in adulthood. According to the type of the congenital disease, these patients were subdivided into 2 groups according to cyanogenic or not heart disease.

Results/Expected results

The average age was 32 years old. A female predominance was objectified (72%). At diagnosis, 46% of our patients were symptomatic with dyspnea. At pre-surgical echocardiographic evaluation, LVEF was preserved in 125 patients (96%) with an average of 65.7 ± 10.4%. 85% of operations were under CPB. 46% of patients used vasoactive drugs upon discharge from CPB. Intra-hospital mortality was 5% and intra-hospital morbidity was 31%. The complications had a favorable evolution. This postoperative morbidity was the cause of a longer hospital stay.

Conclusion/Perspectives

Nowadays, some other techniques seek to register as less invasive alternatives to conventional surgery such as closure of septal defects percutaneously and totally computer-assisted endoscopic occlusion which offers an excellent aesthetic result.