6:00 PM - 6:40 PM
[I-IL-03-1] Late causes of death after congenital cardiac surgery - a population-based six-decade study with 98% follow-up
Introduction: Survival after congenital cardiac surgery has improved significantly during recent decades, yet patients remain at risk for premature death. We investigated late causes of death after congenital cardiac surgery by era and defect severity.
Methods: We obtained data retrospectively from a nation-wide CHD database, including paediatric patients who underwent cardiac surgery at <15 years of age at one of 5 university– or 1 district hospital in Finland 1953-–2009. The Finnish population registry supplied patient survival status. We categorised modes of death into CHD-related and non-CHD-related deaths using ICD diagnostic codes. Deaths among the study population were compared to those among a sex-, age-, birth-time-, and hospital district-matched control population.
Results: 10,964 patients underwent 13,876 operations, with 98% follow-up (10,692). Early (<30 days) and late mortality were 5.6% (613 patients) and 10.4% (1,129 patients), respectively. The incidence of CHD-related death correlated with defect severity. Fatal heart failure (17% with pulmonary hypertension) was the most common mode of CHD-related death, but decreased among those undergoing surgery 1990–2009. The incidence of sudden death was zero after surgery for ASD, VSD, TOF, and TGA 1990–2009 (Table 1). Deaths due to neoplasms, respiratory, neurological, and infectious disease were significantly more common among study patients than the general population. Pneumonia constituted the majority of non-CHD-related deaths among the study population.
Conclusions: CHD-related deaths have decreased, yet challenge survival after surgery for severe defects. Premature deaths are more common among patients than the general population.
Methods: We obtained data retrospectively from a nation-wide CHD database, including paediatric patients who underwent cardiac surgery at <15 years of age at one of 5 university– or 1 district hospital in Finland 1953-–2009. The Finnish population registry supplied patient survival status. We categorised modes of death into CHD-related and non-CHD-related deaths using ICD diagnostic codes. Deaths among the study population were compared to those among a sex-, age-, birth-time-, and hospital district-matched control population.
Results: 10,964 patients underwent 13,876 operations, with 98% follow-up (10,692). Early (<30 days) and late mortality were 5.6% (613 patients) and 10.4% (1,129 patients), respectively. The incidence of CHD-related death correlated with defect severity. Fatal heart failure (17% with pulmonary hypertension) was the most common mode of CHD-related death, but decreased among those undergoing surgery 1990–2009. The incidence of sudden death was zero after surgery for ASD, VSD, TOF, and TGA 1990–2009 (Table 1). Deaths due to neoplasms, respiratory, neurological, and infectious disease were significantly more common among study patients than the general population. Pneumonia constituted the majority of non-CHD-related deaths among the study population.
Conclusions: CHD-related deaths have decreased, yet challenge survival after surgery for severe defects. Premature deaths are more common among patients than the general population.