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Cardiac surgery in adults with high-surgical complexity CHD: results of a network collaborative programme

Vered Gilad1, Francesco Santoro2, Elena Ribera2

  • 11Cardiovascular Department,Istituto Clinico Ligure di Alta Specialità (ICLAS),Rapallo,Italy.

Cardiology in the Young
|August 30, 2017
PubMed

Insights

Adults with congenital heart disease (CHD) benefit from collaborative care. A multidisciplinary program involving pediatric and adult cardiac specialists achieved low mortality and morbidity in complex adult CHD surgeries.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease (ACHD)
  • Cardiac Surgery

Background:

  • Adults with congenital heart disease (CHD) present complex cardiac abnormalities requiring specialized care.
  • A collaborative program integrating pediatric and adult cardiovascular specialists was established to improve access to expert management.
  • This initiative aimed to bridge the gap in specialized care for adults with complex CHD.

Purpose of the Study:

  • To review the experience and analyze surgical outcomes of major cardiac surgery within a collaborative network.
  • To evaluate the effectiveness of a multidisciplinary approach in managing adult CHD patients.

Main Methods:

  • Retrospective review of consecutive patients undergoing major cardiac surgery between January 2010 and December 2013.
  • Analysis focused on patients selected for major cardiac surgery with cardiopulmonary bypass.
  • Evaluation of both early (in-hospital) and late (follow-up) surgical outcomes.

Main Results:

  • Eighty-six out of 433 patients underwent surgery, with a median age of 25.5 years.
  • Most patients had complex conditions, including prior surgeries (74.4%) and sternotomies (64%).
  • Despite high complexity, in-hospital mortality was low (1.1%), with no deaths or heart failure events at 4-year follow-up.

Conclusions:

  • Low mortality and morbidity rates are achievable in complex adult CHD populations.
  • A multidisciplinary environment where pediatric and adult cardiac specialists collaborate is key to successful outcomes.
  • This collaborative model enhances the management of high-surgical complexity adult CHD patients.
Abstract

Keywords:
AdultCHDcardiac surgeryorganisation model

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