Abstract
OBJECTIVESSurgical myocardial revascularization will be increasingly needed in adult patients with congenital heart disease. We investigated the results of coronary artery bypass grafting (CABG) performed on adults by congenital cardiac surgeons at our institution.METHODSWe conducted a retrospective, single-centre study. Adults undergoing isolated or combined CABG from 2004 to 2017 were included. Early and late outcomes were analyzed for the whole cohort. Furthermore, a propensity matched analysis was conducted comparing the results of isolated CABG between congenital and adult surgeons.RESULTSA total of 514 and 113 patients had isolated and combined CABG for acquired heart disease, respectively. A total of 33 patients had myocardial revascularization at the time of surgery for congenital heart disease. Overall early mortality was 1.2%, the rate of re-exploration for bleeding was 4.5%, and an internal mammary artery to left anterior descending artery graft was used in 85.6% patients. One-year survival was 97.5% (96.2–98.8%), and 5-year survival was 88.0% (84.8–91.3%). After propensity matching (468 pairs), early mortality (0.6% vs 1.2%, P = 0.51), re-exploration for bleeding (3.6% vs 3.0%, P = 0.72), use of internal mammary artery to left anterior descending artery graft (92.7% vs 91.9%, P = 0.70) and late survival did not differ between congenital surgeons and adult surgeons, respectively.CONCLUSIONSSurgical myocardial revascularization can be required for adult congenital patients in a broad spectrum of clinical situations. Despite lower volumes, congenital cardiac surgeons perform CABG safely and with results that are comparable to those of the adult surgeons at our centre.
Highlights
The management of children with congenital heart disease (CHD) has improved dramatically over the last few decades; an increasing number of congenital patients will require surgical procedures as adults [1, 2]
Surgical myocardial revascularization can be required for adult congenital patients in a broad spectrum of clinical situations
660 patients underwent Coronary artery bypass grafting (CABG) performed by congenital cardiac surgeons
Summary
The management of children with congenital heart disease (CHD) has improved dramatically over the last few decades; an increasing number of congenital patients will require surgical procedures as adults [1, 2]. A number of congenital conditions such as coronary anomalies may be treated with surgical revascularization in selected cases [5]. Coronary artery bypass grafting (CABG) is the most common heart operation performed worldwide [6]; it is not undertaken routinely by congenital cardiac surgeons in many centres. Our aims were to retrospectively analyze the results of CABG performed on adult patients by congenital cardiac surgeons at our institution, using widely recognized clinical outcomes as quality indicators [6, 7]. We conducted a propensity matched analysis to compare the results of isolated CABG between congenital surgeons and high-volume coronary surgeons at the same centre
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