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Updated: Jun 1, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
[Six-year experience with cardiac surgery in adults with congenital heart disease]
Jana Popelová1, Stepán Cerný, Roman Gebauer
1Oddelení kardiochirurgie, Kardiocentrum Nemocnice Na Homolce, Praha. jana.popelova@homolka.cz
Insights
Adults with congenital heart disease (ACHD) undergoing cardiac surgery have excellent outcomes, with mortality rates below 2%. Key risk factors for mortality include advanced NYHA class, cyanosis, and ventricular dysfunction.
Area of Science:
- Adult cardiac surgery
- Congenital heart disease
- Surgical outcomes
Context:
- Growing population of adults with congenital heart disease (ACHD) require surgical intervention.
- ACHD operations constitute a significant portion (9.5%) of adult cardiac surgeries.
- This study focuses on defining risks and outcomes in adult cardiac surgery for ACHD patients.
Purpose:
- To evaluate the risk and outcomes of cardiac operations in adults with congenital heart disease (ACHD).
- To identify risk factors associated with mortality in ACHD patients undergoing surgery.
Summary:
- A total of 459 ACHD patients underwent surgery between 2005-2010.
- Low mortality rates were observed: 1.1% at 30 days, 1.52% hospital mortality, and 1.3% long-term mortality.
- NYHA class III-IV, cyanosis, and severe ventricular dysfunction were identified as significant mortality risk factors.
Impact:
- Achieved excellent surgical results in older adults with CHD through specialized adult cardiac surgery centers.
- Highlights the importance of identifying and managing specific risk factors like NYHA class, cyanosis, and ventricular dysfunction for improved patient outcomes.
Background:
Increasing number of adults with congenital heart disease (ACHD) require reoperation or primary repair. To define risk and outcome of operations of ACHD performed in adult cardiac surgery.
Methods:
Between 2005-2010 we operated on 459 patients with ACHD, aged 40.4 +/- 15 years. Operations of ACHD represented 9.5% of 4854 cardiac operations in our department.
Results:
The 30-days mortality was 1.1%, hospital mortality was 1.52%, long-term mortality among discharged patients was 1.3%. Reoperations after surgery in childhood represented 39%, repeated reoperations 9%, operations of 3 or 4 valves 2.6%. Robotic surgery or minithoracotomy was performed in 9%. Pulmonary hypertension was present in 11.3%, NYHA III-IV in 30%. The risk factors of mortality were: NYHA class III-IV (p < 0.001), cyanosis (p < 0.001), severe systolic dysfunction of left (p = 0.006) or right ventricle (p < 0.001).We did not confirm increased risk in older patients, women, pulmonary hypertension, reoperations and operations of 3-4 valves.
Conclusions:
Excellent surgical results among older adults with CHD were achieved by the co-operation of paediatric cardiac surgeon within the experienced centre for adult cardiac surgery. The highest risk was found in patients with NYHA class Ill-IV, cyanosis and ventricular dysfunction.
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