Early surgical morbidity and mortality in adults with congenital heart disease: The University of Michigan experience

Ginnie L. Abarbanell, Caren S. Goldberg, Eric J. Devaney, Richard G. Ohye, Edward L. Bove, John R. Charpie

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

Objectives: To review early surgical outcomes in a contemporary series of adults with congenital heart disease (CHD) undergoing cardiac operations at the University of Michigan, and to investigate possible preoperative and intraoperative risk factors for morbidity and mortality. Methods: A retrospective medical record review was performed for all patients ≥18 years of age who underwent open heart operations by a pediatric cardiothoracic surgeon at the University of Michigan Congenital Heart Center between January 1, 1998 and December 31, 2004. Records from a cohort of pediatric patients ages 1-17 years were matched to a subset of the adult patients by surgical procedure and date of operation. Results: In total, 243 cardiac surgical operations were performed in 234 adult patients with CHD. Overall mortality was 4.7% (11/234). The incidence of major postoperative complications was 10% (23/234) with a 19% (45/23) minor complication rate. The most common postoperative complication was atrial arrhythmias in 10.8% (25/234). The presence of preoperative lung or liver disease, prolonged cardiopulmonary bypass and aortic cross clamp times, and postoperative elevated inotropic score and serum lactates were significant predictors of mortality in adults. There was no difference between the adult and pediatric cohorts in terms of mortality and morbidity. Conclusions: The postoperative course in adults following surgery for CHD is generally uncomplicated and early survival should be expected. Certain risk factors for increased mortality in this patient population may include preoperative presence of chronic lung or liver dysfunction, prolonged cardiopulmonary bypass and aortic cross-clamp times, and postoperative elevated inotropic score and serum lactate levels.

Original languageEnglish (US)
Pages (from-to)82-89
Number of pages8
JournalCongenital Heart Disease
Volume3
Issue number2
DOIs
StatePublished - Mar 2008
Externally publishedYes

Keywords

  • Adults
  • Congenital Heart Disease
  • Morbidity
  • Mortality
  • Risk Factors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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