The significance of cardiac surgery scars in adult patients with congenital heart disease.

BACKGROUND: Scars resulting from heart surgery mark patients for life, yet their effect on patients' well-being is unknown. AIM: To determine what spheres of life may be affected by surgical chest scarring. METHODS: A preliminary questionnaire asked 10 random patients at our adult congenital heart disease clinic to describe personal consequences (if any) of having a cardiac surgery scar. Results provided the basis to design another questionnaire which asked specific questions and attempted to rate the effect of scars on identified areas of concern. RESULTS: One hundred consecutive patients attending the clinic (53 males) aged 18 to 50 (mean 27 years) participated. Sixty percent reported that the scar affected them less now than in adolescence. The body was perceived as disfigured by 58%. The scar was concealed by 48% of patients. Attention to the scar made 19% of patients feel negative, 58% neutral and 23% positive. Chest scarring was associated with decreased self-esteem in 20% and decreased self-confidence in 18% of patients. Patients reported less effect of chest scarring on their choice of career, success in life, friendships, sexual relationships and choice of recreation. Sixty-one percent reported a positive effect on appreciation of health. CONCLUSION: Scars resulting from heart surgery may have a considerable effect on patients' body image and several aspects of everyday life.