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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Long-term patient-reported outcomes following congenital heart surgery in adults
Thibault Schaeffer1,2, Pauline Bossers1, Doris Kienmoser1,2
1Department of Congenital and Pediatric Cardiac Surgery, German Heart Center Munich, Technical University of Munich, Munich, Germany.
Insights
Adults with congenital heart disease (ACHD) experience improved wellbeing and life satisfaction years after cardiac surgery. Illness perception is linked to congenital heart disease (CHD) severity.
Area of Science:
- Cardiology
- Adult Congenital Heart Disease (ACHD) Research
- Quality of Life Studies
Background:
- Adults with congenital heart disease (ACHD) often require complex cardiac surgery.
- Long-term outcomes and quality of life (QoL) post-surgery in ACHDs are crucial areas of research.
- Understanding patient-reported outcomes is vital for comprehensive ACHD care.
Purpose of the Study:
- To investigate the long-term impact of cardiac surgery on the quality of life in adults with congenital heart disease (ACHD).
- To assess patient-reported outcomes including perceived health status, life satisfaction, psychological functioning, health behaviors, and illness perception.
- To correlate clinical variables with QoL outcomes and compare them to healthy populations.
Main Methods:
- A single-center, cross-sectional study enrolled 196 adults with congenital heart disease (CHD) who underwent cardiac surgery at age 18+.
- Participants completed online questionnaires assessing patient-reported outcomes and health behaviors.
- Clinical data were analyzed and compared with international and national healthy and ACHD cohorts.
Main Results:
- The majority of ACHDs reported improved subjective wellbeing post-cardiac surgery, with most in NYHA functional class I or II.
- Life satisfaction was comparable to healthy individuals, and health risk behaviors were within expected ranges.
- Illness perception was negatively impacted by CHD severity, number of prior surgeries, and beta-blocker use.
Conclusions:
- Adults with congenital heart disease (ACHD) report significant long-term subjective wellbeing and life satisfaction improvements after cardiac surgery.
- Health behaviors in this cohort are comparable to international benchmarks.
- Illness perception in ACHDs is strongly associated with the underlying severity of their congenital heart disease (CHD).
Objective:
To investigate the long-term impact of cardiac surgery on the quality of life in adults with congenital heart disease (ACHDs).
Methods:
Patients who had undergone cardiac surgery for congenital heart disease (CHD) at the age of 18 years or more were recruited in a single-center, cross-sectional study. The enrolled subjects completed online questionnaires to assess patient-reported outcomes: perceived health status and life satisfaction, psychological functioning, health behaviors, and illness perception. Clinical variables were correlated to the score results, and results were compared to representative samples from international and German national surveys of healthy subjects and ACHDs.
Results:
We enrolled 196 ACHDs (54% women), including 55% with more than one cardiac surgery during their lifetime. The median age at the survey was 43 years, with a median of 13 years since their last cardiac surgery. The majority of patients reported improved subjective wellbeing after cardiac operation and were in functional New York Heart Association class I or II. The severity of underlying CHD, number of previous cardiac operations, and beta-blocker medication had the most substantial negative effects on illness perception. Measured quality of life and health risk behaviors were within the range of values internationally reported for healthy and CHD subjects, respectively.
Conclusions:
ACHD, several years after cardiac surgery, reported a subjective improvement in their wellbeing, a life satisfaction comparable to that of healthy individuals, and low health risk behaviors. Illness perception is strongly correlated with the severity of the underlying CHD.
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