Abstract 14435: Changing Patterns Of Deaths Among Adult Survivors With Congenital Heart Disease: A 30-year Single Centre Experience
Introduction: Advances in heart surgery and cardiology care have dramatically improved survival for patients born with congenital heart disease (CHD) and almost all now survive to adulthood. Many of these adults are, however, at risk of premature death. The aim of this study was to investigate changing patterns of deaths in adults with CHD.
Methods: All deaths (n = 485) and transplantations (n = 50) of adults with CHD at a single tertiary care centre were reviewed for 3 decades between 1980 and 2009.
Results: Parallel to the increase in total patients followed, the number of deaths has increased (Figure 1). The majority of patients (86%) died from cardiac cause and 86% of deceased patients had defects of moderate or great complexity. Compared to the number of deaths, few patients underwent transplantation and transplants did not increase over the last 2 decades. The mean age at time of death increased with each decade (1980-89: 34 ± 13, 1990-99: 40 ± 15, 2000-09: 42 ± 15 years, p <0.001). The most common cardiac defects were cyanotic defects or Eisenmenger syndrome (27%), tetralogy of Fallot (12%), transposition complexes (TGA) with subaortic right ventricle (11%), and single ventricles with Fontan palliation (11%). Deaths in patients with TGA continued to increase between the 2nd and 3rd decade (Figure 2).
Conclusion: Rising numbers of young adults dying from their CHD will present an increasing challenge to institutions and providers who care for them. There is an increase in age at death and there may be a shift in underlying diagnoses, likely reflecting changing operative techniques. Transplantation may be a treatment option for selected patients but may not be available for the majority.
- © 2010 by American Heart Association, Inc.