Abstract 1668: Surgical Trends in the Congenital Heart Disease Population from 1984 to 2004: the Rising Number of Non-Congenital Cardiac Surgeries in Adults
Introduction. The population of congenital heart disease (CHD) patients is increasing. We sought to describe temporal changes in the rates of cardiac surgery (Sx) indexed to the CHD population.
Methods. We identified CHD patients having cardiac surgery from 1984 to 2004 using administrative databases in Quebec. Surgeries were grouped as congenital and non-congenital (including valvular and aortic Sx, arrhythmia Sx, coronary artery bypass, transplants and mechanical hearts). CHD diagnoses conformed to the ICD9 classification. Tetralogy of Fallot, endocardial cushion defects, univentricular hearts, truncus arteriosus and transposition complexes were classified as “severe” lesions; remaining diagnoses were classified as “other” lesions. Yearly rates were calculated as total surgeries/1,000 CHD patients. We used linear regression (the slope of year variable) to estimate average changes in the yearly rates for children and adults.
Results. We identified 70,515 CHD patients having 23,006 cardiac Sx. The number of Sx rose from 753/year in 1984 to 1,473/year in 2004. Non-congenital Sx in adults with “other” CHD tripled over the study period and accounted for most of the observed rise in absolute numbers. Indexed to the CHD population, the overall rate of Sx increased by 28% from 18 to 23/1,000 patients. The largest increase was for non-congenital Sx in adults (slope +5.39, p < 0.001).
Conclusion. The rate of cardiac Sx in adults with CHD doubled from 1984 to 2004, largely due to a rise in the number of non-congenital Sx. The aging population of adults with CHD is requiring a growing number of surgical interventions to manage cardiac complications.