TY - JOUR T1 - Contemporary cardiac surgery for adults with congenital heart disease JF - Heart JO - Heart SP - 1194 LP - 1202 DO - 10.1136/heartjnl-2016-310384 VL - 103 IS - 15 AU - Sylvain Beurtheret AU - Oktay Tutarel AU - Gerhard Paul Diller AU - Cathy West AU - Evangelia Ntalarizou AU - Noémie Resseguier AU - Vasileios Papaioannou AU - Richard Jabbour AU - Victoria Simpkin AU - Anthony J Bastin AU - Sonya V Babu-Narayan AU - Beatrice Bonello AU - Wei Li AU - ​Babulal Sethia AU - Hideki Uemura AU - Michael A Gatzoulis AU - Darryl Shore Y1 - 2017/08/01 UR - http://heart.bmj.com/content/103/15/1194.abstract N2 - Objective Advances in early management of congenital heart disease (CHD) have led to an exponential growth in adults with CHD (ACHD). Many of these patients require cardiac surgery. This study sought to examine outcome and its predictors for ACHD cardiac surgery.Methods This is an observational cohort study of prospectively collected data on 1090 consecutive adult patients with CHD, undergoing 1130 cardiac operations for CHD at the Royal Brompton Hospital between 2002 and 2011. Early mortality was the primary outcome measure. Midterm to longer-term survival, cumulative incidence of reoperation, other interventions and/or new-onset arrhythmia were secondary outcome measures. Predictors of early/total mortality were identified.Results Age at surgery was 35±15 years, 53% male, 52.3% were in New York Heart Association (NYHA) class I, 37.2% in class II and 10.4% in class III/IV. Early mortality was 1.77% with independent predictors NYHA class ≥ III, tricuspid annular plane systolic excursion (TAPSE) <15 mm and female gender. Over a mean follow-up of 2.8±2.6 years, 46 patients died. Baseline predictors of total mortality were NYHA class ≥ III, TAPSE <15 mm and non-elective surgery. The number of sternotomies was not independently associated with neither early nor total mortality. At 10 years, probability of survival was 94%. NYHA class among survivors was significantly improved, compared with baseline.Conclusions Contemporary cardiac surgery for ACHD performed at a single, tertiary reference centre with a multidisciplinary approach is associated with low mortality and improved functional status. Also, our findings emphasise the point that surgery should not be delayed because of reluctance to reoperate only. ER -