Abstract 1866: Actual Prospects to Survive Into Adulthood in Patients With Congenital Heart Disease
We sought to investigate the proportion of patients with congenital heart disease (CHD) that currently survive into adulthood; to compare the actuarial survival of patients who were born between 1990 and 1999 with patients who were born in the 1970s and 1980s; and to evaluate the actuarial survival according to the severity and the type of heart defect. We reviewed the administrative and clinical database of the CHD program of our hospital, comprising 17,044 patients with CHD.
Findings: In our study population, 3829 CHD patients were born between 1990 and 1999. In this cohort, actuarial survival to the age of 18 years was 89.3%. This survival rate was significantly better than the 84.6% of patients who were born in the 1980s (n=3516) (log rank=37.9; df=1; p<0.0001), or the 81.5% of patients who were born in the 1970s (n=2740) (log rank=57.4; df=1; p<0.0001). For the patients born in the 1990s, actuarial survival into adulthood for a mild heart defect was 98.5%, whereas it was 90.4% in patients with moderate severity lesions, and 59.4% in patients with complex conditions (log rank=580; df=2; p<0.0001). Survival was relatively good in patients with ventricular septal defect (97.7%); mitral valve anomalies (97.3%); pulmonary valve abnormality (97.2%); secundum atrial septal defect (97.0%); aortic valve abnormality (95.2%); left ventricle outflow tract obstruction (93.5%); aortic abnormality (91.7%); and coarctation of the aorta (90.6%). Survival to the age of 18 years was lower in patients with pre-existing pulmonary arterial hypertension (84.9%); tetralogy of Fallot (84.4%); atrioventricular septal defect (78.1%); transposition of the great arteries (77.9%); univentricular physiology (53.6%); or hypoplastic left heart syndrome (22.8%). Obviously, survival between diagnostic categories was significantly different (log rank=1207; df=13; p<0.0001).
Conclusions: This study demonstrated that the prospects to survive into adulthood in today’s youngsters with CHD has increased to about 90%. These findings can be used for workforce planning for adult congenital heart disease programs.