Outcomes in adult congenital heart surgery: Analysis of the Society of Thoracic Surgeons Database

Christopher E. Mascio, Sara K. Pasquali, Jeffrey P. Jacobs, Marshall L Jacobs, Erle H. Austin

Research output: Contribution to journalArticle

Abstract

Objective: Outcomes data for adults undergoing congenital heart surgery are limited. Previous analyses used administrative data or focused on single-center outcomes. We describe the most common operations, patient characteristics, and postoperative outcomes using a multicenter clinical database. Methods: The study included adults (aged ≥ 18 years) listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2000-2009). We describe patient characteristics and morbidity and mortality, and examine congenital procedures in the Society of Thoracic Surgeons Adult Cardiac Surgery Database to permit consideration of the primary dataset within a broader context. Results: A total of 5265 patients (68 centers) from the Society of Thoracic Surgeons Congenital Heart Surgery Database were included. Patients' median age was 25 years (interquartile range, 20-35). Common preoperative risk factors included noncardiac abnormalities (17%) and arrhythmia (14%). Overall, in-hospital mortality was 2.1%, 27% had 1 or more complication, and median length of stay was 5 days. Common operations included right ventricular outflow tract procedures (21%) and pacemaker/arrhythmia procedures (20%). We further evaluated cardiopulmonary bypass procedures in more than 100 patients. Mortality ranged from 0% (atrial septal defect repair) to 11% (Fontan revision/conversion). Separate evaluation of the Society of Thoracic Surgeons Adult Cardiac Surgery Database revealed 39,872 adults undergoing congenital heart operations. Conclusions: Most adult congenital heart operations listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database are performed in the third to fourth decades of life; approximately half are for right heart pathology or arrhythmia. Many patients have complications, but mortality is low with the exception of those undergoing Fontan revision/conversion. Many more adults undergoing congenital heart surgery are entered into the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Original languageEnglish (US)
Pages (from-to)1090-1097
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume142
Issue number5
DOIs
StatePublished - Nov 2011
Externally publishedYes

Fingerprint

Thoracic Surgery
Databases
Cardiac Arrhythmias
Mortality
Atrial Heart Septal Defects
Hospital Mortality
Cardiopulmonary Bypass
Length of Stay
Pathology
Morbidity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Outcomes in adult congenital heart surgery : Analysis of the Society of Thoracic Surgeons Database. / Mascio, Christopher E.; Pasquali, Sara K.; Jacobs, Jeffrey P.; Jacobs, Marshall L; Austin, Erle H.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 142, No. 5, 11.2011, p. 1090-1097.

Research output: Contribution to journalArticle

Mascio, Christopher E. ; Pasquali, Sara K. ; Jacobs, Jeffrey P. ; Jacobs, Marshall L ; Austin, Erle H. / Outcomes in adult congenital heart surgery : Analysis of the Society of Thoracic Surgeons Database. In: Journal of Thoracic and Cardiovascular Surgery. 2011 ; Vol. 142, No. 5. pp. 1090-1097.
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abstract = "Objective: Outcomes data for adults undergoing congenital heart surgery are limited. Previous analyses used administrative data or focused on single-center outcomes. We describe the most common operations, patient characteristics, and postoperative outcomes using a multicenter clinical database. Methods: The study included adults (aged ≥ 18 years) listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2000-2009). We describe patient characteristics and morbidity and mortality, and examine congenital procedures in the Society of Thoracic Surgeons Adult Cardiac Surgery Database to permit consideration of the primary dataset within a broader context. Results: A total of 5265 patients (68 centers) from the Society of Thoracic Surgeons Congenital Heart Surgery Database were included. Patients' median age was 25 years (interquartile range, 20-35). Common preoperative risk factors included noncardiac abnormalities (17{\%}) and arrhythmia (14{\%}). Overall, in-hospital mortality was 2.1{\%}, 27{\%} had 1 or more complication, and median length of stay was 5 days. Common operations included right ventricular outflow tract procedures (21{\%}) and pacemaker/arrhythmia procedures (20{\%}). We further evaluated cardiopulmonary bypass procedures in more than 100 patients. Mortality ranged from 0{\%} (atrial septal defect repair) to 11{\%} (Fontan revision/conversion). Separate evaluation of the Society of Thoracic Surgeons Adult Cardiac Surgery Database revealed 39,872 adults undergoing congenital heart operations. Conclusions: Most adult congenital heart operations listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database are performed in the third to fourth decades of life; approximately half are for right heart pathology or arrhythmia. Many patients have complications, but mortality is low with the exception of those undergoing Fontan revision/conversion. Many more adults undergoing congenital heart surgery are entered into the Society of Thoracic Surgeons Adult Cardiac Surgery Database.",
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