PMID- 28270427
OWN - NLM
STAT- MEDLINE
DCOM- 20170810
LR  - 20220129
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 103
IP  - 15
DP  - 2017 Aug
TI  - Contemporary cardiac surgery for adults with congenital heart disease.
PG  - 1194-1202
LID - 10.1136/heartjnl-2016-310384 [doi]
AB  - OBJECTIVE: Advances in early management of congenital heart disease (CHD) have 
      led to an exponential growth in adults with CHD (ACHD). Many of these patients 
      require cardiac surgery. This study sought to examine outcome and its predictors 
      for ACHD cardiac surgery. METHODS: This is an observational cohort study of 
      prospectively collected data on 1090 consecutive adult patients with CHD, 
      undergoing 1130 cardiac operations for CHD at the Royal Brompton Hospital between 
      2002 and 2011. Early mortality was the primary outcome measure. Midterm to 
      longer-term survival, cumulative incidence of reoperation, other interventions 
      and/or new-onset arrhythmia were secondary outcome measures. Predictors of 
      early/total mortality were identified. RESULTS: Age at surgery was 35+/-15 years, 
      53% male, 52.3% were in New York Heart Association (NYHA) class I, 37.2% in class 
      II and 10.4% in class III/IV. Early mortality was 1.77% with independent 
      predictors NYHA class >/= III, tricuspid annular plane systolic excursion (TAPSE) 
      <15 mm and female gender. Over a mean follow-up of 2.8+/-2.6 years, 46 patients 
      died. Baseline predictors of total mortality were NYHA class >/= III, TAPSE <15 mm 
      and non-elective surgery. The number of sternotomies was not independently 
      associated with neither early nor total mortality. At 10 years, probability of 
      survival was 94%. NYHA class among survivors was significantly improved, compared 
      with baseline. CONCLUSIONS: Contemporary cardiac surgery for ACHD performed at a 
      single, tertiary reference centre with a multidisciplinary approach is associated 
      with low mortality and improved functional status. Also, our findings emphasise 
      the point that surgery should not be delayed because of reluctance to reoperate 
      only.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2017. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Beurtheret, Sylvain
AU  - Beurtheret S
AD  - Department of Congenital Cardiac Surgery, Royal Brompton Hospital, London, UK.
AD  - Department of Adult Cardiac Surgery, Saint Joseph Hospital, Marseille, France.
FAU - Tutarel, Oktay
AU  - Tutarel O
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Diller, Gerhard Paul
AU  - Diller GP
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
AD  - NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, 
      UK.
FAU - West, Cathy
AU  - West C
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Ntalarizou, Evangelia
AU  - Ntalarizou E
AD  - Department of Congenital Cardiac Surgery, Royal Brompton Hospital, London, UK.
FAU - Resseguier, Noemie
AU  - Resseguier N
AD  - Department of Biostatistic and Public Health, La Timone Hospital, Marseille, 
      France.
FAU - Papaioannou, Vasileios
AU  - Papaioannou V
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Jabbour, Richard
AU  - Jabbour R
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Simpkin, Victoria
AU  - Simpkin V
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Bastin, Anthony J
AU  - Bastin AJ
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Babu-Narayan, Sonya V
AU  - Babu-Narayan SV
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
AD  - NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, 
      UK.
FAU - Bonello, Beatrice
AU  - Bonello B
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Li, Wei
AU  - Li W
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Sethia, Babulal
AU  - Sethia B
AD  - Department of Congenital Cardiac Surgery, Royal Brompton Hospital, London, UK.
FAU - Uemura, Hideki
AU  - Uemura H
AD  - Department of Congenital Cardiac Surgery, Royal Brompton Hospital, London, UK.
FAU - Gatzoulis, Michael A
AU  - Gatzoulis MA
AD  - Adult Congenital Heart Centre & National Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
AD  - NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, 
      UK.
FAU - Shore, Darryl
AU  - Shore D
AD  - Department of Congenital Cardiac Surgery, Royal Brompton Hospital, London, UK.
LA  - eng
GR  - FS/11/38/28864/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20170307
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Surgical Procedures/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Defects, Congenital/mortality/*surgery
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate/trends
MH  - Treatment Outcome
MH  - United Kingdom/epidemiology
MH  - Young Adult
OTO - NOTNLM
OT  - adults - congenital heart disease - cardiac surgery
COIS- Competing interests: None declared.
EDAT- 2017/03/09 06:00
MHDA- 2017/08/11 06:00
CRDT- 2017/03/09 06:00
PHST- 2016/08/14 00:00 [received]
PHST- 2017/01/25 00:00 [revised]
PHST- 2017/01/25 00:00 [accepted]
PHST- 2017/03/09 06:00 [pubmed]
PHST- 2017/08/11 06:00 [medline]
PHST- 2017/03/09 06:00 [entrez]
AID - heartjnl-2016-310384 [pii]
AID - 10.1136/heartjnl-2016-310384 [doi]
PST - ppublish
SO  - Heart. 2017 Aug;103(15):1194-1202. doi: 10.1136/heartjnl-2016-310384. Epub 2017 
      Mar 7.