[Risk factors for surgery of congenital heart disease in adults: twenty-two years of experience. Who should operate them?]. / Factores de riesgo asociados a la cirugía del adulto con cardiopatía congénita: 22 años de experiencia. ¿Quién debe intervenirlos?
Arch Cardiol Mex
; 84(4): 262-72, 2014.
Article
in Es
| MEDLINE
| ID: mdl-25242638
ABSTRACT
OBJECTIVE:
To assess the association between mortality in surgery of congenital heart disease in adults, and factors related to patients and operations.METHOD:
Descriptive study of operations performed by specialized surgeons in congenital heart surgery (238), adult acquired surgery (117), and specialty residents (108). The association of mortality with surgical risk and complexity, specialization of surgeon, cardiopulmonary by-pass and aortic cross clamping was assessed fitting logistic regression models.RESULTS:
A total of 463 operations were included (442 with cardiopulmonary by-pass) in the study performed between 1991 and 2012. Median age at surgery 34; 52.8% were women. First surgery 295, reoperation 168. Median score of Aristotle was 6.8, with significantly higher complexity since 2001, after restructuring the Unit. Overall hospital mortality was 3.9%. Mortality was significantly associated to number of previous surgeries (OR 5.02; 95%CI 1.44-17.52), operations by acquired heart disease surgeons (OR 3.53; 95%CI 1.14-10.98), higher Aristotle (OR 1,64; 95%CI 1.18-2.29), and high cardiopulmonary by-pass time (OR 1.13; 95%CI 1.07-1.19).CONCLUSIONS:
Surgery of congenital heart disease in adults has been performed with low mortality. High complexity interventions, prolonged cardiopulmonary by-pass times and multiple reoperations were associated to higher mortality. Participation of cardiac surgeons specialized in congenital heart disease is associated with better outcomes.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Heart Defects, Congenital
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
Es
Journal:
Arch Cardiol Mex
Journal subject:
CARDIOLOGIA
Year:
2014
Type:
Article