Adult congenital cardiac surgery in Indonesia

Karina V. Wilamarta, Yoga Yuniadi, Jusuf Rachmat, Dicky Fakhri, Tarmizi Hakim, Maizul Anwar

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)639-645
Number of pages7
JournalCardiology in the Young
Volume21
Issue number6
DOIs
Publication statusPublished - 1 Dec 2011

Keywords

  • developing country
  • Grown-up congenital heart
  • long-term surgical results

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