Skip to main content
SpringerLink
Log in

Surgical Considerations in Adult Patients with Congenital Heart Disease

  • Chapter
  • First Online:
Cardiac CT and MR for Adult Congenital Heart Disease

  • 2556 Accesses

Abstract

The number of adults with congenital heart disease (CHD) has dramatically increased over the past decades. It is estimated that more than a million adults with CHD are in the United States alone (Hoffman, Am Heart J 147:425–439, 2004) and it is expected that this number will continue to grow as the population increases. This is secondary to the significant improvement in cardiac surgery and perioperative care. Now, at least 95 % of newborns with CHD will survive to adulthood (Warnes, J Am Coll Cardiol 46:1–8, 2005); however, despite this improvement, residual or recurrent lesions may progress over years and decades resulting in an increase in the need for reoperation. Valve procedures are the most common, and many patients may require numerous surgical procedures or interventions over a lifetime. This chapter will review the surgical issues associated with reoperation in adults with CHD and discuss the role of available imaging modalities in the perioperative management of this growing patient population.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hoffman JI, Kaplan S, Liberthson RR. Prevalence of congenital heart disease. Am Heart J. 2004;147:425–39.

    Article  PubMed  Google Scholar 

  2. Warnes CA. The adult with congenital heart disease: born to be bad? J Am Coll Cardiol. 2005;46:1–8.

    Article  PubMed  Google Scholar 

  3. Christenson JT, Schmziger M, Simmat F. Reoperative coronary artery bypass. Risk factors for early mortality and late survival. Eur J Cardiothorac Surg. 1997;1:129–33.

    Article  Google Scholar 

  4. Park CB, Suri RM, Burkhart HM, Greason KL, Dearani JA, Schaff HV, Sundt 3rd TM. Identifying patients at particular risk of injury during repeat sternotomy: analysis of 2555 cardiac reoperations. J Thorac Cardiovasc Surg. 2010;140(5):1028–35.

    Article  PubMed  Google Scholar 

  5. Walther T, Rastan A, Dähnert I, et al. A novel adhesion barrier facilitates reoperations in complex congenital cardiac surgery. J Thorac Cardiovasc Surg. 2005;129:359–63.

    Article  PubMed  Google Scholar 

  6. Kirshbom PM, Myung RJ, Simsic JM, et al. One thousand repeat sternotomies for congenital cardiac surgery: risk factors for reentry injury. Ann Thorac Surg. 2009;88:158–61.

    Article  PubMed  Google Scholar 

  7. Akl BF, Pert SB, Wernly JA. Use of a sagittal oscillating saw for repeat sternotomy: a safer and simpler technique. Ann Thorac Surg. 1984;38:646–7.

    Article  PubMed  CAS  Google Scholar 

  8. Yalonetsky S, Tobler D, Greutmann M, et al. Cardiac magnetic resonance imaging and the assessment of ebstein anomaly in adults. Am J Cardiol. 2011;107(5): 767–73.

    Article  PubMed  Google Scholar 

  9. Koelling TM, Aaronson KD, Cody RJ, et al. Prognostic significance of mitral regurgitation and tricuspid regurgitation in patients with left ventricular systolic dysfunction. Am Heart J. 2002;144: 524–9.

    Article  PubMed  Google Scholar 

  10. Lee JW, Song JM, Park JP, et al. Long-term prognosis of isolated significant tricuspid regurgitation. Circ J. 2010;74:375–80.

    Article  PubMed  Google Scholar 

  11. Shibata Y, Sato M, Chanda J, et al. Isolated tricuspid regurgitation due to atypical morphology of anteriorposterior leaflets in an adult: a case report and review of the literature. J Cardiovasc Surg. 1999;40:527–30.

    CAS  Google Scholar 

  12. Said SM, Burkhart HM, Dearani JA. Surgical management of congenital (non-Ebstein) tricuspid valve regurgitation. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2012;15(1):46–60.

    Article  PubMed  Google Scholar 

  13. Lin G, Nishimura RA, Connolly HM, et al. Severe symptomatic tricuspid valve regurgitation due to permanent pacemaker or implantable cardioverter-defibrillator leads. J Am Coll Cardiol. 2005;45:1672–5.

    Article  PubMed  Google Scholar 

  14. Ishino K, Stumper O, De Giovanni JJ, et al. The modified Norwood procedure for hypoplastic left heart syndrome: early to intermediate results of 120 patients with particular reference to aortic arch repair. J Thorac Cardiovasc Surg. 1999;117:920–30.

    Article  PubMed  CAS  Google Scholar 

  15. Said SM, Burkhart HM, Dearani JA. Fontan connections: past, present, and future. World J Pediatr Cong Heart Surg. 2012;32:171–82.

    Article  Google Scholar 

  16. Laudito A, Brook MM, Suleman S, et al. The Ross procedure in children and young adults: a word of caution. J Thorac Cardiovasc Surg. 2001;122:147–53.

    Article  PubMed  CAS  Google Scholar 

  17. Said SM, Dearani JA, Silversides CK, et al. Longer-term issues for young adults with hypoplastic left heart syndrome: contraception, pregnancy, transition, transfer, counseling, and re-operation. Cardiol Young. 2011;21 Suppl 2:93–100.

    Article  PubMed  Google Scholar 

  18. Dore A, Glancy DL, Stone S, Menashe VD, Somerville J. Cardiac surgery for grown-up congenital heart patients: survey of 307 consecutive operations from 1991–1994. Am J Cardiol. 1997;80:906–13.

    Article  PubMed  CAS  Google Scholar 

  19. Perloff JK, Natterson PD. Atrial aarhythmias in adults after repair of teratlogy of Fallot. Ann Thorac Surg. 1995;91:2118–9.

    CAS  Google Scholar 

  20. Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 Guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 2008;118:2395–451.

    Article  PubMed  Google Scholar 

  21. Bonhoeffer P, Boudjemline Y, Saliba Z, et al. Percutaneous replacement of pulmonary valve in a right ventricle to pulmonary artery prosthetic conduit with valve dysfunction. Lancet. 2000;356:1403–5.

    Article  PubMed  CAS  Google Scholar 

  22. McElhinney DB, Hellebrand WE, Zahn EM, et al. Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US Melody valve trial. Circulation. 2010;122:507–16.

    Article  PubMed  Google Scholar 

  23. Bergersen L, Lock JE. What is the current option of first choice for treatment of pulmonary arterial stenosis? Cardiol Young. 2006;16(4):329–38.

    Article  PubMed  Google Scholar 

  24. Ing FF. Delivery of stents to target lesions: techniques of intraoperative stent implantation and intraoperative angiograms. Pediatr Cardiol. 2005;26(3):260–6.

    Article  PubMed  CAS  Google Scholar 

  25. Shaffer KM, Mullins CE, Grifka RG, O’Laughlin MP, McMahon W, Ing FF, Nihill MR. Intravascular stents in congenital heart disease: short- and long-term results from a large single-center experience. J Am Coll Cardiol. 1998;31(3):661–7.

    Article  PubMed  CAS  Google Scholar 

  26. Bacha EA, Marshall AC, McElhinney DB, del Nido PJ. Hybrid pediatric cardiac surgery. Pediatr Cardiol. 2005;26(4):315–22.

    Article  PubMed  CAS  Google Scholar 

  27. Menon SC, Cetta F, Dearani JA, Burkhart HM, Cabalka AK, Hagler DJ. Hybrid intraoperative pulmonary artery stent placement for congenital heart disease. Am J Cardiol. 2008;102:1737–41.

    Article  PubMed  Google Scholar 

  28. Koh M, Yagihara T, Uemura H, et al. Intermediate results of the double-switch operations for atrioventricular discordance. Ann Thorac Surg. 2006;81:671–7.

    Article  PubMed  Google Scholar 

  29. Dragulescu A, Sidibe N, Aubert F, Fraisse A. Successful use of covered stent to treat superior systemic baffle obstruction and leak after atrial switch procedure. Pediatr Cardiol. 2008;29:954–6.

    Article  PubMed  Google Scholar 

  30. Ebeid MR, Gaymes CH, McMullan MR, Shores JC, Smith JC, Joransen JA. Catheter management of occluded superior baffle after atrial switch procedures for transposition of great vessels. Am J Cardiol. 2005;95:782–6.

    Article  PubMed  Google Scholar 

  31. Sareyyupoglu B, Burkhart HM, Hagler DJ, Dearani JA, Cabalka A, Cetta F, Schaff HV. Hybrid approach to repair of pulmonary venous baffle obstruction after atrial switch operation. Ann Thorac Surg. 2009;88(5):1710–1.

    Article  PubMed  Google Scholar 

  32. Holst KA, Dearani JA, Burkhart HM, Connolly HM, Warnes CA, Li Z, Schaff HV. Risk factors and early outcomes of multiple reoperations in adults with congenital heart disease. Ann Thorac Surg. 2011;92:122–30.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiovascular Surgery, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    Sameh M. Said MD, Harold M. Burkhart MD & Joseph A. Dearani MD

Authors
  1. Sameh M. Said MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Harold M. Burkhart MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joseph A. Dearani MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph A. Dearani MD .

Editor information

Editors and Affiliations

  1. Department of Radiology, USC University Hospital Keck School of Medicine, Los Angeles, California, USA

    Farhood Saremi

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Said, S.M., Burkhart, H.M., Dearani, J.A. (2014). Surgical Considerations in Adult Patients with Congenital Heart Disease. In: Saremi, F. (eds) Cardiac CT and MR for Adult Congenital Heart Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8875-0_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8875-0_19

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8874-3

  • Online ISBN: 978-1-4614-8875-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation