A survey and outcome of treatment of congenital heart defects at the Pediatric Heart Center, University Hospital Motol, Prague, during 1977-2003
Abstract
Aim: To determine the structure of surgical procedures for congenital heart defects in a major national center and to point to problems seen at follow-up in adults undergoing cardiac surgery in their childhood. Group of patients: A total of 9,450 operations for congenital heart defects were performed at the Pediatric Heart Center, University Hospital Motol, Prague, over the 1977-2003 period.
These include 7,500 open-heart procedures with cardiopulmonary bypass and 1,950 closed-heart procedures. On average, 450 children are operated on at this center every year, 50% of them are newborns and infants under 1 year of age.
Heart reoperations account for 11% of the procedures. Results: Surgical mortality decreased to 1% over the past 5 years.
Most patients are in very good condition and have a good quality of life. There are already 2,500 adult patients operated on in childhood for a congenital heart defect.
Half of them require continuous follow-up by a cardiologist for possible unfavorable development of their operated complex heart defect. Special attention is given to patients undergoing ventricular outflow tract reconstruction involving conduits or homografts (n = 453), those having valve replacement in childhood (n = 649), patients with univentricular heart or systemic right ventricle and those with potential development of ventricular dysfunction or arrhythmia.
Conclusion: The rational development of heart operations with generally low operative mortality rates even in very young children with rare heart defects is described in a large series of children operated on at a centralized department of pediatric cardiac surgery. Most patients survive until adulthood with a good quality of life.
Half of them require permanent follow-up by a cardiologist.