Abstract
Aim: A retrospective evaluation of the outcomes of a program of systematic care of adults with congenital heart disease (CHD) at Na Homolce Hospital. Patients: Out of more than 1,900 adults with congenital heart disease, 128 were operated on from April 2005 through January 2007.
The mean age was 41 +- 15 years. Results: Surgical mortality was zero as was 30-day mortality; 3 patients were lost to long-term follow-up.
The average hospitalization time was 11.7 +- 5 days. Reoperations accounted for 46% of all operations, 15% were repeat reoperations.
Total cavopulmonary connection (TCPC) as the first surgical procedure in the adult age was undertaken in two cases, reoperations of complex CHD were performed in seven cases (reoperation after TCPC, reoperation after Senning, Mustard or Rastelli correction). Besides surgical antiarrhythmic procedures, we performed 17 successful transcatheter radiofrequency ablation procedures and nine ICD implantations.
Post-procedural NYHA class improved significantly, from 2.3 +- 0.7 to 1.3 +- 0.2; p < 0.001. Conclusion: Operations and reoperations of CHD can be performed in adults with excellent outcomes, low mortality and morbidity rates, and short hospitalization times in settings providing comprehensive care and teamwork.
A condition sine qua non is a large body of experience, hence centralization of cardiac surgical care of CHD in adults is warranted.