Abstract 122: Adult Congenital Heart Surgery Safely Performed at Pediatric Hospitals: 115 Consecutive Open Heart Surgeries Without a Mortality or Significant Morbidity

Abstract

Objectives: With increasing numbers of adult patients with congenital heart disease requiring surgical intervention, determining the best treatment location and treatment team is very important. We evaluated the results of treating all adults at a Children’s Hospital. Methods: We reviewed the surgical outcomes of all adult patients who underwent surgical repair of congenital heart disease on cardiopulmonary bypass, at the pediatric hospital, from July 2006 through June 2011. Results: The same surgeon operated on 115 patients with a median age of 27.31.8, average weight 74.82.3, 72.2% were redo, 1.7% requiring femoral cannulation and 53.9% were male. There were no mortalities. 67.8% were extubated in the OR, 2.6% required re-intubation, 87% were done bloodlessly. There were 4 major events (1) Re-exploration for bleeding, (2) Ventricular fibrillation that required shock and converted, (3) Minor stroke with no permanent neurological deficit, and (4) Vascular injury to axillary artery requiring return to the OR. Of the patients, 70 procedures were done on the left side with 32 aortic procedures, and 135 procedures on the right side including 9 patients with Hybrid PA stenting. 24 patients had cyro-ablation of RVOT for ventricular arrhythmias and 14 had atrial ablations. Conclusions: There is a growing need to develop care strategies for adults with congenital heart disease. By developing a focus of care at pediatric hospital, adults received outstanding surgical results with very little morbidity or mortality.