• Angel Aroca, Luz Polo, Napoleón Pérez-Farinós, Ana E González, Montserrat Bret, Elizabeth Aguilar, and José M Oliver.
• Servicio de Cirugía Cardíaca Infantil y Unidad de Cardiopatías Congénitas del Adulto, Hospital Universitario La Paz, Madrid, España. Electronic address: aarocap@telefonica.net.
• Arch Cardiol Mex. 2014 Oct 1;84(4):262-72.

ObjectiveTo assess the association between mortality in surgery of congenital heart disease in adults, and factors related to patients and operations.MethodDescriptive study of operations performed by specialized surgeons in congenital heart surgery (238), adult acquired surgery (117), and specialty residents (108). The association of mortality with surgical risk and complexity, specialization of surgeon, cardiopulmonary by-pass and aortic cross clamping was assessed fitting logistic regression models.ResultsA total of 463 operations were included (442 with cardiopulmonary by-pass) in the study performed between 1991 and 2012. Median age at surgery: 34; 52.8% were women. First surgery: 295, reoperation: 168. Median score of Aristotle was 6.8, with significantly higher complexity since 2001, after restructuring the Unit. Overall hospital mortality was 3.9%. Mortality was significantly associated to number of previous surgeries (OR: 5.02; 95%CI: 1.44-17.52), operations by acquired heart disease surgeons (OR: 3.53; 95%CI: 1.14-10.98), higher Aristotle (OR: 1,64; 95%CI: 1.18-2.29), and high cardiopulmonary by-pass time (OR: 1.13; 95%CI: 1.07-1.19).ConclusionsSurgery of congenital heart disease in adults has been performed with low mortality. High complexity interventions, prolonged cardiopulmonary by-pass times and multiple reoperations were associated to higher mortality. Participation of cardiac surgeons specialized in congenital heart disease is associated with better outcomes.Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

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