Intensive care outcome of adult patients operated on for congenital heart disease

Intensive Care Med. 2007 Mar;33(3):524-8. doi: 10.1007/s00134-006-0462-5. Epub 2006 Dec 20.

Abstract

Objective: To describe the ICU outcome and the most frequent complications observed in adult patients operated on for a congenital heart disease.

Design and setting: Retrospective analysis of prospectively collected data and chart review in an adult cardiovascular ICU of a university hospital.

Patients: 156 patients older than 15 years with congenital heart disease undergoing cardiac surgery between June 2001 and June 2005.

Results: According to the initial cardiac malformation, patients were divided in four groups with different operative risk based on the Euroscore: those diagnosed bicuspid aortic valve (n = 73) had a score of 5, those with tetralogy of Fallot (n = 33) 5.5, those with simple cardiac defect (n = 26) 3, and those with complex malformations (n = 24) 6. Only two patients (one with tetralogy of Fallot and one with complex malformations) died during the hospitalization (1.2%).

Conclusion: Euroscore clearly overestimates the risk of surgery in this population of adults with congenital heart disease. Mortality and morbidity were low in those diagnosed bicuspid aortic valve, tetralogy of Fallot, or simple cardiac defect, justifying early surgery for incipient complications. Patients with complex congenital defect require prolonged ICU stay, sometimes with mechanical cardiac support, but their overall good outcome justifies these efforts.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aortic Valve / abnormalities
  • Cardiac Surgical Procedures* / adverse effects
  • Female
  • Heart Defects, Congenital / surgery*
  • Humans
  • Intensive Care Units
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications* / prevention & control
  • Retrospective Studies
  • Risk Factors
  • Tetralogy of Fallot / surgery
  • Treatment Outcome