Jelena Pabst von Ohain1,2, Eleonora Tonino1,2, Harald Kaemmerer3, Julie Cleuziou1,2, Peter Ewert3, Rüdiger Lange4, Jürgen Hörer1,2. 1. Department of Congenital and Paediatric Heart Surgery, German Heart Centre Munich, Technische Universität München, Munich, Germany. 2. Division of Congenital and Paediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilian-Universität, Munich, Germany. 3. Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technische Universität München, Munich, Germany. 4. Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universität München, Munich, Germany.
Abstract
BACKGROUND: Our historical overview in the form of a cohort study aimed to describe the changes in the cardiac operations in adults with congenital heart disease (ACHD), over 45 years in the German Heart Centre in Munich. METHODS: The study population comprised all consecutive patients aged 18 or more, who underwent surgery for congenital heart disease (CHD) at the German Heart Centre Munich, between 1974 and 2018. Operations were coded according to the Adult Congenital Heart Surgery (ACHS) score. Two-tailed chi-square test was used for testing on differences in the frequency of procedural groups between the decades. RESULTS: During the examined 45-year period, 2,882 operations were performed on ACHD. The number of operations per year increased with a correlation coefficient r=0.533, P<0.001. Overall operative mortality was 3.2%. There was no significant difference in mortality over the decades. The percentage of primary CHD diagnosis being the indication for the operation was 99% in the 1970s and decreased significantly to 56% in the 2010s, P<0.001. There was a significant decrease in the relative frequency of atrial septal defect closures from 45% in the 1970s and 1980s to 9% in 2010s (P<0.001). Coarctation repair made up 15% of all operations in the 1970s, then dropped significantly to 1% in the 2010s (P<0.001). The percentage of reoperations increased significantly from 7% in the 1970s to 50% in 2010s (P<0.001). CONCLUSIONS: The spectrum of cardiac surgery in ACHD changed significantly over the last 45 years, from primary repair of septal defects and coarctation of the aorta in the 1970s to complex reoperations in the 2010s. 2021 Cardiovascular Diagnosis and Therapy. All rights reserved.
BACKGROUND: Our historical overview in the form of a cohort study aimed to describe the changes in the cardiac operations in adults with congenital heart disease (ACHD), over 45 years in the German Heart Centre in Munich. METHODS: The study population comprised all consecutive patients aged 18 or more, who underwent surgery for congenital heart disease (CHD) at the German Heart Centre Munich, between 1974 and 2018. Operations were coded according to the Adult Congenital Heart Surgery (ACHS) score. Two-tailed chi-square test was used for testing on differences in the frequency of procedural groups between the decades. RESULTS: During the examined 45-year period, 2,882 operations were performed on ACHD. The number of operations per year increased with a correlation coefficient r=0.533, P<0.001. Overall operative mortality was 3.2%. There was no significant difference in mortality over the decades. The percentage of primary CHD diagnosis being the indication for the operation was 99% in the 1970s and decreased significantly to 56% in the 2010s, P<0.001. There was a significant decrease in the relative frequency of atrial septal defect closures from 45% in the 1970s and 1980s to 9% in 2010s (P<0.001). Coarctation repair made up 15% of all operations in the 1970s, then dropped significantly to 1% in the 2010s (P<0.001). The percentage of reoperations increased significantly from 7% in the 1970s to 50% in 2010s (P<0.001). CONCLUSIONS: The spectrum of cardiac surgery in ACHD changed significantly over the last 45 years, from primary repair of septal defects and coarctation of the aorta in the 1970s to complex reoperations in the 2010s. 2021 Cardiovascular Diagnosis and Therapy. All rights reserved.
Authors: Andreas Eicken; Peter Ewert; Alfred Hager; Bjoern Peters; Sohrab Fratz; Titus Kuehne; Raymonde Busch; John Hess; Felix Berger Journal: Eur Heart J Date: 2011-01-27 Impact factor: 29.983
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