Surgical Treatment of Adult Congenital Heart Disease_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANGRong-yuan ¹ ,  ZHANGYan-bo ¹ , YANGKe-ming ² , HUANGHai-bo ¹ , SHIChen ¹ , MENGYan-hai ¹ , CHANGShuo ¹ , YANGQiu-lan ¹ , LIUZi-na ¹ , LIULing-feng ¹

1. Intensive Care Unit, Fu Wai Angiocardiopathy Hospital edo-Heart Center, Chinese Academy of Medical Sciences, Beijing 100045, P.R.China;
2. Department of Cardiac Surgery, Fu Wai Angiocardiopathy Hospital edo-Heart Center, Chinese Academy of Medical Sciences, Beijing 100045, P.R.China;

Corresponding author：

ZHANGYan-bo, Email: yanbozhang@126.com

Keywords：

Congenital heart disease; Operation; Adult

DOI：

10.7507/1007-4848.20160137

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Objective To investigate the results of the surgical treatment of adult congenital heart disease (ACHD). Methods We retrospectively analyzed the clinical data of 502 patients with ACHD underwent operation treatment in Fu Wai Hospital between January 2012 and June 2015. There were 205 males and 297 females at age of 18-65(34.01±11.97) years and weight of 19-96 (58.60±12.60) kg. Results Atrial septal defect had the highest incidence of ACHD, the proportion accounted for 43.8%.The followed was ventricular sepal defect, accounting for 26.6%. And the third is tetralogy of Fallot, accounting for 5.4%. The age ranged from 18 to 65 years. A percentage of 65.13% patients received operation when they are younger than 40 years, with the most patients at age of 20-29 years, the least patients at age of 30-39 years. We completed a total of 471 patients of early orthodontic treatment with operation success rate at 99.57%. We completed 29 patients palliative operation with early operation success rate at 96.55%. And there were 2 patients with re-operation at success rate of 100.00%. The postoperative patients with ventilator assisted time was 19.03 h. The mechanical ventilation time was 19.03 h. ICU treatment time was 2.22 d. Postoperative complications occurred in 51 patients with incidence rate at 10.15%. Conclusion It is very important to impose proper surgical method on different patients. The operation doctor should be trained skillfully. Perioperative management is also a key stage to the success of the operation.

Citation： ZHANGRong-yuan, ZHANGYan-bo, YANGKe-ming, HUANGHai-bo, SHIChen, MENGYan-hai, CHANGShuo, YANGQiu-lan, LIUZi-na, LIULing-feng. Surgical Treatment of Adult Congenital Heart Disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(6): 573-576. doi: 10.7507/1007-4848.20160137 Copy

1.	Heery E, Sheehan AM, While AE, et al. Experiences and outcomes of transition from pediatric to adult health care services for young people with congenital heart disease: a systematic review. Congenit Heart Dis, 2015, 9(10): 1111-1125.
2.	Hays L. Transition to adult congenital heart disease care: a review. J Pediatr Nurs, 2015, 19(15): S0882-S5963.
3.	Nguyen LT, Maul TM. Current and future status of adult congenital training in North America. Am J Cardiol, 2015, 3(15): S0002-S0005.
4.	Ávila P, Mercier LA, et al. Adult congenital heart disease: a growing epidemic. Dore A Can J Cardiol, 2014, 30(12 Suppl): S410-S419.
5.	Kempny A1, Fernández-Jiménez R, Tutarel O, et al. Meeting the challenge: the evolving global landscape of adult congenital heart disease. Int J Cardiol, 2013, 168(6): 5182-5189.
6.	Khairy P, Ionescu-Ittu R, Mackie AS, et al. Changing mortality in congenital heart disease. J Am Coll Cardiol, 2010, 56(14): 1149-1157.
7.	Tutarel O. Acquired heart conditions in adults with congenital heart disease: a growing problem. Heart, 2014, 100(17): 1317-1321.
8.	Van der Bom T. The prevalence of adult congenital heart disease, results from a systematic review and evidence based calculation. Am Heart J, 2012, 164(4): 568-575.
9.	Patel MS, Kogon BE. Care of the adult congenital heart disease patient in the United States: a summary of the current system. Pediatr Cardiol, 2010, 31(4):511-514.
10.	Nyboe C, Fenger-Grøn M, Nielsen-Kudsk JE, et al. Closure of secundum atrial septal defects in the adult and elderly patients. Eur J Cardiothorac Surg, 2013, 43(4):752-757.
11.	Kaemmerer H, Gorenflo M, Hoeper M, et al. Pulmonary arterial hypertension in patients with congenital heart disease: current issues and health care situation. Dtsch Med Wochenschr, 2013, 138(23):1247-1252.
12.	张燕搏, 蒙延海, 杨克明, 等. 成人先天性心脏病心外管道全腔静脉肺动脉连接术后早期临床结果. 中国胸心血管外科临床杂志, 2015, 22(9): 816-820.
13.	Radke RM, Diller GP, Baumgartner H. The challenge of managing pulmonary arterial hypertension in adults with congenital heart disease. Expert Rev Cardiovasc Ther, 2013, 11(7): 919-931.
14.	Greutmann M, Tobler D. Changing epidemiology and mortality in adult congenital heart disease: looking into the future. Future Cardiol, 2012, 8(2):171-177.
15.	Heery E, Sheehan AM, While AE, et al. Experiences and outcomes of transition from pediatric to adult health care services for young people with congenital heart disease: a systematic review. Congenit Heart Dis, 2015, 9(10): 1111-1125.
16.	Marelli AJ, Mackie AS, Ionescu-Ittu R. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation, 2007, 115(2): 163-172.
17.	杨克明. 复杂成人先心病发展趋势及诊治特点. 中国循环杂志, 2013, 28(z1):195.
18.	张燕搏, 张荣媛, 刘子娜, 等. 175例成人先心病患者外科治疗术后早期结果. 中华实用诊断与治疗杂志, 2015, 29(4): 338-340.
19.	Aroca A, Polo L, Pérez-Farinós N, et al. Risk factors for surgery of congenital heart disease in adults: twenty-two years of experience. Who should operate them? Arch Cardiol Mex, 2014, 84(4): 262-272.
20.	Cohen SB, Ginde S, Bartz PJ, et al. Extracardiac complications in adults with congenital heart disease. Congenit Heart Dis, 2013, 8(5): 370-380.

1. Heery E, Sheehan AM, While AE, et al. Experiences and outcomes of transition from pediatric to adult health care services for young people with congenital heart disease: a systematic review. Congenit Heart Dis, 2015, 9(10): 1111-1125.
2. Hays L. Transition to adult congenital heart disease care: a review. J Pediatr Nurs, 2015, 19(15): S0882-S5963.
3. Nguyen LT, Maul TM. Current and future status of adult congenital training in North America. Am J Cardiol, 2015, 3(15): S0002-S0005.
4. Ávila P, Mercier LA, et al. Adult congenital heart disease: a growing epidemic. Dore A Can J Cardiol, 2014, 30(12 Suppl): S410-S419.
5. Kempny A1, Fernández-Jiménez R, Tutarel O, et al. Meeting the challenge: the evolving global landscape of adult congenital heart disease. Int J Cardiol, 2013, 168(6): 5182-5189.
6. Khairy P, Ionescu-Ittu R, Mackie AS, et al. Changing mortality in congenital heart disease. J Am Coll Cardiol, 2010, 56(14): 1149-1157.
7. Tutarel O. Acquired heart conditions in adults with congenital heart disease: a growing problem. Heart, 2014, 100(17): 1317-1321.
8. Van der Bom T. The prevalence of adult congenital heart disease, results from a systematic review and evidence based calculation. Am Heart J, 2012, 164(4): 568-575.
9. Patel MS, Kogon BE. Care of the adult congenital heart disease patient in the United States: a summary of the current system. Pediatr Cardiol, 2010, 31(4):511-514.
10. Nyboe C, Fenger-Grøn M, Nielsen-Kudsk JE, et al. Closure of secundum atrial septal defects in the adult and elderly patients. Eur J Cardiothorac Surg, 2013, 43(4):752-757.
11. Kaemmerer H, Gorenflo M, Hoeper M, et al. Pulmonary arterial hypertension in patients with congenital heart disease: current issues and health care situation. Dtsch Med Wochenschr, 2013, 138(23):1247-1252.
12. 张燕搏, 蒙延海, 杨克明, 等. 成人先天性心脏病心外管道全腔静脉肺动脉连接术后早期临床结果. 中国胸心血管外科临床杂志, 2015, 22(9): 816-820.
13. Radke RM, Diller GP, Baumgartner H. The challenge of managing pulmonary arterial hypertension in adults with congenital heart disease. Expert Rev Cardiovasc Ther, 2013, 11(7): 919-931.
14. Greutmann M, Tobler D. Changing epidemiology and mortality in adult congenital heart disease: looking into the future. Future Cardiol, 2012, 8(2):171-177.
15. Heery E, Sheehan AM, While AE, et al. Experiences and outcomes of transition from pediatric to adult health care services for young people with congenital heart disease: a systematic review. Congenit Heart Dis, 2015, 9(10): 1111-1125.
16. Marelli AJ, Mackie AS, Ionescu-Ittu R. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation, 2007, 115(2): 163-172.
17. 杨克明. 复杂成人先心病发展趋势及诊治特点. 中国循环杂志, 2013, 28(z1):195.
18. 张燕搏, 张荣媛, 刘子娜, 等. 175例成人先心病患者外科治疗术后早期结果. 中华实用诊断与治疗杂志, 2015, 29(4): 338-340.
19. Aroca A, Polo L, Pérez-Farinós N, et al. Risk factors for surgery of congenital heart disease in adults: twenty-two years of experience. Who should operate them? Arch Cardiol Mex, 2014, 84(4): 262-272.
20. Cohen SB, Ginde S, Bartz PJ, et al. Extracardiac complications in adults with congenital heart disease. Congenit Heart Dis, 2013, 8(5): 370-380.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical Treatment of Adult Congenital Heart Disease

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