Avaliação do tratamento cirúrgico da cardiopatia congênita em pacientes com idade superior a 16 anos

Canêo, Luiz Fernando; Jatene, Marcelo Biscegli; Riso, Arlindo; Tanamati, Carla; Penha, Juliano Gomes; Moreira, Luíz Felipe Pinho; Atik, Edmar; Trindade, Evelinda; Stolf, Noedir A. G

doi:10.1590/s0066-782x2012005000030

Cited by 10 publications

(12 citation statements)

References 21 publications

(26 reference statements)

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“…Despite the comparison of our data with those disclosed by a recent report [3] coming from a pioneer center in the country is possible in some aspects, they both differ fundamentally in terms of patient population, institutional characteristics, detailment of postoperative complications and information regarding follow-up. These differences, as we can see it, add to the informations we consider important regarding the management to these patients.…”

Section: Late Resultsmentioning

confidence: 55%

“…Another fact which certainly influences results is the number of operated patients. Our experience is relatively small when compared with other publications where the numbers varied from 438 to 2012 [3,[13][14][15]19].…”

Section: Immediate Resultsmentioning

confidence: 63%

“…The data here presented are concerned to a tertiary institution dedicated to congenital heart disease treatment for the last 40 years. However, it should be noted that the complex forms of defects started being treated in the last 20 years, which gives a peculiar characteristic to our experience, with an important prevalence of mild and moderately complex lesions differing, in some respect, of the experience of pioneer institutions in the country [3].…”

Section: Discussionmentioning

confidence: 83%

“…Reports of global experiences with this type of patients in the country were not available until recently when a relevant experience was published [3]. However, results with specific groups of patients may be found [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Adult congenital heart disease: experience with the surgical approach

Amaral

Rodrigues

Manso

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Objective: To report the institution experience with the surgical treatment of adults with congenital heart disease due to the increasing number of these patients and the need for a better discussion of the subject.Methods: Retrospective analysis describing demographic data, risk factors and results.Results: 191 patients between 16 and 74 years old were operated on. Primary correction was done in 171 cases, 93 (55%) for atrial septal defect repair. Among 20 (12%) reoperations, pulmonary valve replacement was done in six cases. The mean intensive care and hospital stay were 2.7 and 8.5 days respectively, significantly greater for the reoperated cases (P=0.001). The mean bypass and clamping times were 68.6 and 44.7 minutes respectively, greater for the reoperated cases (P<0.0001 and P=0.0003 respectively). Hospital mortality was 4.2% and male sex, functional class III-IV and older age at operation were predictive risk factors. Significant complications were more frequent in the reoperated cases (P<0.003), mainly atrial flutter and fibrillation. Among 183 patients discharged, 149 (82%) are being followed and atrial flutter and fibrillation are common. The mean functional class value improved significantly after operation (1.66 to 1.11; P<0.0001). The estimated survival was 96.2% in six years. Conclusion:Heart surgery in adults with congenital heart disease can be accomplished with low mortality and functional class improvement. Immediate and late complications are frequent. Multicenter studies are important to better characterize this patient population in the country.Descriptors: Heart defects, congenital. Adult. Cardiac surgical procedures.Resumo Objetivo: Relatar a experiência da instituição com o tratamento cirúrgico de adultos com cardiopatia congênita devido ao crescente aumento no número desses pacientes e consequentes necessidades de maior discussão do tema.Métodos: Análise retrospectiva dos pacientes operados, com análise de dados demográficos, fatores de risco e resultados.Resultados: Cento e noventa e um pacientes, com idade entre 16 e 74 anos, foram operados. Cirurgia primária foi realizada em 171 pacientes, 93 (55%) com comunicação interatrial. Dentre 20 (12%) reoperações, substituição de valva pulmonar ocorreu em seis casos. Os tempos médios de unidade de terapia intensiva e hospitalar foram 2,7 e 8,5 dias, respectivamente, maiores nas reoperações (P=0,001). Os tempos médios de cir- 372Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Rev Bras Cir Cardiovasc 2013;28(3):371-9Amaral FTV, et al. -Adult congenital heart disease: experience with the surgical approach city area (n=40, 20%) or in the region (n=133, 70%) while 17 (10%) were referred from other states. An Excel data base was created containing general information of the patients, possible preoperative risk factors such as diabetes, cyanosis, smoking, systemic hypertension, obesity and chronic lung disease, detailed information regarding the surgical procedure, hospital complications and follow up information.The preoperative data collec...

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Section: Late Resultsmentioning

confidence: 55%

Section: Immediate Resultsmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Adult congenital heart disease: experience with the surgical approach

Amaral

Rodrigues

Manso

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…It is interesting to mention that, as far as we know, in the last 16 years, only ten papers were published in indexed Brazilian journals regarding CHD in adults [ 16 , 34 , 36 - 43 ] . However, a change in this perspective is soon expected.…”

Section: Researchmentioning

confidence: 99%

Recommendations for starting a grown up congenital heart disease (GUCH) unit

Amaral¹,

Manso²,

Schmidt³

et al. 2015

Revista Brasileira De Cirurgia Cardiovascular

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During the last decades, advances in diagnosis and treatment of congenital heart disease have allowed many individuals to reach adulthood. Due mainly to the great diagnostic diversity and to the co-morbidities usually present in this age group, these patients demand assistance in a multidisciplinary facility if an adequate attention is aimed. In this paper we reviewed, based in the international literature and also on the authors’ experience, the structural conditions that should be available for these patients. We highlighted aspects like the facility characteristics, the criteria usually adopted for patient transfer from the paediatric setting, the composition of the medical and para- medical staff taking into account the specific problems, and also the model of outpatient and in-hospital assistance. We also emphasized the importance of patient data storage, the fundamental necessity of institutional support and also the compromise to offer professional training. The crucial relevance of clinical research is also approached, particularly the development of multicenter studies as an appropriate methodology for this heterogeneous patient population.

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