Progress in Late Results Among Pediatric Cardiac Surgery Patients: A Population-Based 6-Decade Study With 98% Follow-Up | Journal Scan

Study Questions:

What are the long-term results of 60 years of congenital heart surgery in a single country?

Methods:

A retrospective study was performed using a national cardiac surgery database for surgical data and the Finnish Population Registry for death/emigration data. Survival was determined using the Kaplan-Meier method, and the survival rate was compared to a sex- and age-matched general population.

Results:

During the study period of 1953-2009, 13,786 cardiac operations were performed. Follow-up was present for 98% of patients. The 60-year survival for patients undergoing cardiac surgery was 70% as compared with 86% for the general population. The long-term survival of patients with severe defects improved significantly over time. The mean age at operation decreased from 8.9 to 2.2 years, and the early mortality decreased from a maximum of 7% in the ‘70s to 3% in the 2000s.

Conclusions:

The authors concluded that these patients are diagnosed and treated at an increasingly younger age. There have been substantial improvements in early and late results among pediatric cardiac surgery patients.

Perspective:

This study took advantage of a national congenital heart surgery database as well as a relatively stable patient population, allowing for 98% follow-up. The study confirmed that repair has been undertaken for increasingly complex congenital heart defects, with improving short- and long-term outcomes. Multiple factors likely contributed to improved outcomes, including improved diagnostics, surgical techniques, and intensive care. Specific to this study, congenital cardiac surgery was centralized to a single center in the late 1990s, which may have contributed to improved outcomes as well.

Clinical Topics: Cardiac Surgery, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Cardiac Surgery and CHD & Pediatrics, Congenital Heart Disease, CHD & Pediatrics and Interventions, CHD & Pediatrics and Quality Improvement, Interventions and Structural Heart Disease

Keywords: Cardiac Surgical Procedures, Heart Defects, Congenital, Pediatrics, Registries, Retrospective Studies, Follow-Up Studies, Child


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