Congenital cardiovascular anomalies in adults: Results of surgical treatment in 167 patients over age 35

Abstract

Congenital cardiovascular anomalies are an infrequent but important cause of heart disease in adults. Variations in blood volume during and after operation are less critical in adults than in children, and intracardiac repair is frequently easier from a technical standpoint in the larger adult heart. A series of 167 patients over age 35 is reviewed. All underwent operations for a variety of cardiovascular anomalies including (in decreasing order of frequency) atrial septal defect (secundum), coarctation of aorta, ventricular septal defect, pulmonary stenosis, atrial septal defect (primum), patent ductus arteriosus, tetralogy of Fallot, aortic stenosis, vascular ring, and total anomalous pulmonary venous drainage. The over-all mortality was 9 per cent and varied according to age, severity of pulmonary hypertension, and presence of congestive heart failure. Technical factors in which adults differ from children are chiefly those concerned with degenerative changes such as atherosclerosis. Mortality in this series of 167 adult patients is comparable to that encountered in a group of 2,353 patients less than 35 years of age undergoing operations for congenital cardiovascular anomalies. This study indicates that surgical correction of congenital cardiovascular defects may be accomplished in adults within an acceptable low mortality rate and with gratifying results.