Cardiothoracic and Vascular Anesthesia
Risk Factors and Early Outcomes of Multiple Reoperations in Adults With Congenital Heart Disease
Holst KA, Dearani JA, Burkhart HM, et al (Mayo Clinic and Foundation, Rochester, MN) Ann Thorac Surg 92:122-130, 2011§
Advances in treatment of congenital heart disease (CHD) have resulted in most patients surviving to adulthood. Despite surgical “correction,” the need for reoperation(s) persists, and there are few outcome data. This study examined early postoperative results to determine risk factors for cardiac injury and early death in adults with CHD undergoing repeat median sternotomy.
Data from the most recent median sternotomy of 984 adults (49% male) with CHD were analyzed. Mean age at operation was 36.4 years. Diagnoses were conotruncal anomaly, 361 (37%); Ebstein/Tricuspid valve, 174 (18%); pulmonary stenosis/right ventricular outflow tract obstruction, 92 (9%); single ventricle, 71 (7%); atrioventricular septal defect, 64 (7%); subaortic stenosis, 62 (6%); aortic arch abnormalities, 23 (2%); anomalous pulmonary vein, 21 (2%); Marfan syndrome, 14 (1%); and other, 102 (10%).