Surgical Outcomes of Adult Congenital Heart Disease
with Left to Right Shunt at Siriraj Hospital
Teerapong Tocharoenchok MD*, Thaworn Subtaweesin MD*,
Somchai Sriyoschati MD*, Punnarerk Thongcharoen MD*, Kriangkrai Tantiwongkosri MD*
Affiliation :
* Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
Background : Outcomes of surgical treatment of adult congenital heart disease (ACHD) in developing country are scant
but are of critical importance for caring of these patients.
Objective : We studied characteristic and surgical repair outcomes of simple ACHD at Siriraj Hospital.
Material and Method: We studied 297 adults with atrial septal defect (ASD), ventricular septal defect (VSD), or patent
ductus arteriosus (PDA) whom underwent surgical repair between January 2006 and September 2014. There were 211 ASD,
80 VSD, and 6 PDA. We focused on perioperative data, follow-up data, and factor(s) associated with adverse events.
Results : Of 297 patients, 37.4% were males; mean age was 41.8 years (range, 20-78 years). Pulmonary hypertension and
valvular regurgitation (mitral, tricuspid, or aortic) were presented in 74.7% and 35.0% of the patients, respectively. Majority
of defects were closed with patching (85.4% for ASD and 82.7% for VSD), while the rest were closed directly. Of the 190
concomitant procedures, most of them were tricuspid repair (28.9%), and mitral repair (17.4%). There were eight hospital
deaths (2.7%). At median follow-up of 25 months (range, 1-102 months), the mean functional classification was reduced
from 1.9 to 1.1 (p<0.01). There were five re-interventions and four late deaths. Overall survival was 96.1% at five years
and 76.1% at eight years. Concomitant procedure(s), tricuspid, and mitral regurgitation were associated with worse survival.
Concomitant procedure(s), mitral, and aortic regurgitation were associated with re-intervention.
Conclusion : Outcomes of surgical repair of simple ACHD were good. Valvular regurgitation and concomitant procedure(s)
adversely affected the outcomes.
Keywords : Adult congenital heart disease, ASD, VSD, PDA, Surgery, Outcomes
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