TY - JOUR
T1 - Adult congenital cardiac surgery in Indonesia
AU - Wilamarta, Karina V.
AU - Yuniadi, Yoga
AU - Rachmat, Jusuf
AU - Fakhri, Dicky
AU - Hakim, Tarmizi
AU - Anwar, Maizul
PY - 2011/12
Y1 - 2011/12
N2 - Background Successful paediatric cardiac surgery and cardiology treatment has resulted in an increase in the use of surgery as a method of treatment of congenital cardiac disease in adult population. However, late detection and lower socio-economic condition in developing countries might change patientsâ characteristics by the time they come for treatment. This study aimed to elaborate the long-term surgical results of adult congenital cardiac disease in Indonesia as a developing country.Methods and results We reviewed retrospectively all adult congenital cardiac disease patients with a mean age of 28 years plus or minus 9.5 years, who underwent surgery at National Cardiovascular Center. The types of procedures used were corrective in 338 patients (89.2%), palliative in 10 patients (2.6%), and re-operations in 31 patients (8.2%). The overall hospital mortality rate was 2.6% but as high as 20% with palliative surgery. Post-operative New York Heart Association class III-IV is the only independent predictor of death at 60 months (hazard ratio 61.48, 95% confidence interval 9.41-401.69, p<0.001). The survival rates were 96.3% and 95% for overall and non-atrial septal defect in patients at 60 months, which was highest in corrective procedures (97.6%). The percentage of patients free of re-operation at 5 yearsâ follow-up was 85.4% and 42.7% at 10 years.Conclusion In developing countries, surgical treatment of adult congenital cardiac disease is effective and safe, with an overall survival rate of 96.3% at 60 months. Due to high mortality rate, palliative surgery of a non-atrial septal defect patient is recommended to be discontinued. The independent predictor of mortality was post-operative New York Heart Association functional class III-IV.
AB - Background Successful paediatric cardiac surgery and cardiology treatment has resulted in an increase in the use of surgery as a method of treatment of congenital cardiac disease in adult population. However, late detection and lower socio-economic condition in developing countries might change patientsâ characteristics by the time they come for treatment. This study aimed to elaborate the long-term surgical results of adult congenital cardiac disease in Indonesia as a developing country.Methods and results We reviewed retrospectively all adult congenital cardiac disease patients with a mean age of 28 years plus or minus 9.5 years, who underwent surgery at National Cardiovascular Center. The types of procedures used were corrective in 338 patients (89.2%), palliative in 10 patients (2.6%), and re-operations in 31 patients (8.2%). The overall hospital mortality rate was 2.6% but as high as 20% with palliative surgery. Post-operative New York Heart Association class III-IV is the only independent predictor of death at 60 months (hazard ratio 61.48, 95% confidence interval 9.41-401.69, p<0.001). The survival rates were 96.3% and 95% for overall and non-atrial septal defect in patients at 60 months, which was highest in corrective procedures (97.6%). The percentage of patients free of re-operation at 5 yearsâ follow-up was 85.4% and 42.7% at 10 years.Conclusion In developing countries, surgical treatment of adult congenital cardiac disease is effective and safe, with an overall survival rate of 96.3% at 60 months. Due to high mortality rate, palliative surgery of a non-atrial septal defect patient is recommended to be discontinued. The independent predictor of mortality was post-operative New York Heart Association functional class III-IV.
KW - Grown-up congenital heart
KW - developing country
KW - long-term surgical results
UR - http://www.scopus.com/inward/record.url?scp=80155135786&partnerID=8YFLogxK
U2 - 10.1017/S1047951111000552
DO - 10.1017/S1047951111000552
M3 - Article
C2 - 21729515
AN - SCOPUS:80155135786
VL - 21
SP - 639
EP - 645
JO - Cardiology in the Young
JF - Cardiology in the Young
SN - 1047-9511
IS - 6
ER -