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Mortality remains high after surgery for congenital heart defects

HealthDay News — Long-term mortality after congenital heart surgery exceeds that of the general population for all forms of congenital heart defects (CDs), according to a study published in the May 29 issue of the Journal of the American College of Cardiology.

Logan G. Spector, Ph.D., of the University of Minnesota in Minneapolis, and colleagues used data from the Pediatric Cardiac Care Consortium’s Pediatric Cardiac Surgery Registry to perform a survival analysis among 35,998 patients who survived their first congenital heart surgery under the age of 21. years of age. Their survival was compared to that of the general population using standardized mortality ratios (SMR).

The researchers found that over a median follow-up of 18 years, 3,191 deaths occurred, with an overall SMR of 8.3. The 15-year SMR fell from 12.7 at the start of the era (1982 to 1992) to 10 at the end of the era (1998 to 2003). Even for mild forms of coronary artery disease, the SMR remained high (persistent ductus arteriosus, SMR 4.5; atrial septal defects, SMR 4.9). The SMR decreased the most for patients with transposition of the great arteries (early: 11 versus late: 3.8), complete atrioventricular canal (31.3 versus 15.3) and single ventricle (53.7 versus 31, 3).

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“Survival has improved over time, particularly for severe defects with significant changes in their management strategy, but still lags behind the general population,” the authors write.

One author disclosed financial ties to Medtronic.

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