National Practice Patterns for Management of Adult Congenital Heart Disease

Karamlou, Tara; Diggs, Brian S.; Person, Thomas D.; Ungerleider, Ross M.; Welke, Karl F.

doi:10.1161/circulationaha.108.776963

Cited by 139 publications

(33 citation statements)

References 21 publications

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“…The overall in-hospital mortality rate for adult patients with congenital heart defects was 4.71% (95% CI, 4.19 to 5.23), with a significant reduction in mortality observed when surgery was performed on adult patients with congenital heart defects by pediatric versus nonpediatric heart surgeons (1.87% versus 4.84%; P <0.0001). 24 …”

Section: Congenital Cardiovascular Defectsmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2011 Update

Roger¹,

Go²,

et al. 2011

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Summary Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update. The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on disease morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document. Indeed, since 1999, the Statistical Update has been cited more than 8700 times in the literature (including citations of all annual versions). In 2009 alone, the various Statistical Updates were cited ≈1600 times (data from ISI Web of Science). In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas. For this year’s edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year and added a new chapter detailing how family history and genetics play a role in cardiovascular disease (CVD) risk. Also, the 2011 Statistical Update is a major source for monitoring both cardiovascular health and disease in the population, with a focus on progress toward achievement of the AHA’s 2020 Impact Goals. Below are a few highlights from this year’s Update. Death Rates From CVD Have Declined, Yet the Burden of Disease Remains High The 2007 overall death rate from CVD (International Classification of Diseases 10, I00–I99) was 251.2 per 100 000. The rates were 294.0 per 100 000 for white males, 405.9 per 100 000 for black males, 205.7 per 100 000 for white females, and 286.1 per 100 000 for black females. From 1997 to 2007, the death rate from CVD declined 27.8%. Mortality data for 2007 show that CVD (I00–I99; Q20–Q28) accounted for 33.6% (813 804) of all 2 243 712 deaths in 2007, or 1 of every 2.9 deaths in the United States. On the basis of 2007 mortality rate data, more than 2200 Americans die of CVD each day, an average of 1 death every 39 seconds. More than 150 000 Americans killed by CVD (I00–I99) in 2007 were <65 years of age. In 2007, nearly 33% of deaths due to CVD occurred before the age of 75 years, which is well before the average life expectancy of 77.9 years. Coronary heart disease caused ≈1 of every 6 deaths in the United States in 2007. Coronary heart disease mortality in 2007 was 406 351. Each year, an estimated 785 000 Americans will have a new coronary attack, and ≈470 000 will have a recurrent attack. It is estimated that an additional 195 000 silent first myocardial infarctions occur each year. Ap...

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Section: Congenital Cardiovascular Defectsmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2011 Update

Roger¹,

Go²,

et al. 2011

View full text Add to dashboard Cite

show abstract

“…The overall in-hospital mortality rate for adult congenital heart defect patients was 4.71% (95% CI 4.19% to 5.23%), with a significant reduction in mortality observed when surgery was performed on adult congenital heart defect patients by pediatric versus nonpediatric heart surgeons (1.87% versus 4.84%; P <0.0001). 33 …”

Section: Congenital Cardiovascular Defectsmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2012 Update

Roger¹,

Go²,

et al. 2012

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“…1,3 Although both 30-day mortality and in-hospital mortality are likely to be associated with similar risk factors, in-hospital mortality that includes deaths after 30 days is a better measure of operative mortality 18,19 and is likely to be more homogeneous with respect to mechanisms compared with mortality within 30 days (or any other specified interval) that includes postdischarge deaths. Therefore, in addition to its clinical importance, in-hospital mortality provides a more accurate assessment of early mortality, and determining which factors are associated with it may allow for interventions to reduce pretransplant risk and improve postoperative management.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with in-hospital mortality in infants undergoing heart transplantation in the United States

Gandhi

Almond

Singh

et al. 2011

The Journal of Thoracic and Cardiovascular Surgery

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Objective Infants undergoing heart transplantation have the highest early posttransplant mortality of any age group. We sought to determine the pretransplantation factors associated with in-hospital mortality in transplanted infants in the current era. Methods All infants under 12 months of age who underwent primary heart transplantation during a recent 10-year period (1999-2009) in the United States were identified using the Organ Procurement and Transplant Network database. Multivariable logistic regression was used to identify independent pretransplantation factors associated with in-hospital mortality. Results Of 730 infants in the study (median age 3.8 months), 462 (63%) had congenital heart disease, 282 (39%) were supported by a ventilator, 94 (13%) with extracorporeal membrane oxygenation, and 22 (3%) with a ventricular assist device at the time of transplantation. Overall, 82 (11.2%) infants died before their initial hospital discharge. In adjusted analysis, in-hospital mortality was associated with repaired congenital heart disease (odds ratio [OR], 3.6; 95% confidence interval [CI], 1.8, 7.2), unrepaired congenital heart disease not on prostaglandin E (OR, 2.8; CI, 1.3, 6.1), extracorporeal membrane oxygenator support (OR, 6.1; CI, 2.8, 13.4), ventilator support (OR, 4.4; CI, 2.3, 8.3), creatinine clearance less than 40 mL · min−1 · 1.73 m−2 (OR, 3.1; CI, 1.7, 5.3), and dialysis (OR, 6.2; CI, 2.1, 18.3) at transplantation. Conclusions One in 9 infants undergoing heart transplantation dies before hospital discharge. Pretranplantation factors associated with early mortality include congenital heart disease, extracorporeal membrane oxygenator support, mechanical ventilation, and renal failure. Risk stratification for early posttransplant mortality among infants listed for heart transplantation may improve decision-making for transplant eligibility, organ allocation, and posttransplant interventions to reduce mortality.

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National Practice Patterns for Management of Adult Congenital Heart Disease

Cited by 139 publications

References 21 publications

Heart Disease and Stroke Statistics—2011 Update

Heart Disease and Stroke Statistics—2011 Update

Heart Disease and Stroke Statistics—2012 Update

Factors associated with in-hospital mortality in infants undergoing heart transplantation in the United States

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