Children with severe congenital heart disease undergo surgery at a median age of 3.6 weeks, and the timing of surgery is similar across geographic regions for most types of severe congenital heart disease. This was revealed in a study published in an academic journal. American Heart Association Journal.

As part of EUROlinkCAT, researchers investigated the timing of first cardiac surgical intervention, number of cardiac surgical interventions, postoperative mortality, and prevalence of severe congenital heart disease during the first 5 years of life in nine European regions and six countries. We evaluated the survival rate of children born in the United States. project.

The analysis included data on 5,693 children born with severe congenital heart defects from 1995 to 2014.

Median age at first surgical intervention was 3.6 (95% CI, 2.6-4.5) weeks (age ≤5 years) for all children born with severe congenital heart disease, 78% (95% CI, 70%-85%). Thirty-six percent (95% CI, 31% to 42%) received the procedure within the first year of life between ages 1 and 4.

Children with severe congenital heart disease underwent a median of 3.2 surgeries during the first 5 years of life (95% CI, 2.6-3.9). Children with right-sided hypoplastic heart disease (HRH) and left-sided hypoplastic heart disease (HLH) had the highest median number of cardiac surgeries during the first 5 years of life, each with 5.0 (95%) CI, 3.4-6.5) and 4.4 times (95 times). % CI, 3.1-5.6) cardiac surgery.

The timing of initial surgery for certain types of severe congenital heart disease was generally consistent within the first few weeks of life for transposition of the great arteries (TGA), abnormal pulmonary venous return, and aortic coarctation.

Postoperative 30-day mortality was highest for surgeries performed during the first month of life (0–28 days), 7.0% (95% CI, 6.1% to 8.0%). . Postoperative mortality was 3.8% (95% CI, 3.2% to 4.5%) for children 29 days to 1 year of age, 1.7% (95% CI, 1.2% to 2.5%) for children 1 to 4 years of age; It was 1.9%. % (95% CI, 1.0% to 3.5%) for ages 5 to 9 years. Children with Ebstein anomaly, HLH, HRH, and common truncus arteriosus had the highest postoperative mortality rate.

Postoperative 30-day mortality rates for TGA and tetralogy of Fallot were similar across the nine geographical regions, with the exception of Wales, where mortality from atrioventricular septal defects was higher than in other regions.

The researchers noted that there was limited information on the exact repairs performed, and no data were available on when the diagnosis was made or when patients might be referred to a tertiary surgical center.

“There were no significant differences in the timing and number of surgical procedures for children with CHD across the nine Western European regions.” [congenital heart defects]” wrote the study authors. “Despite the overall prognosis of most CHDs being good, some lesions are still associated with substantial postoperative mortality and a 5-year survival rate of less than 90%. The results of this study , which could help medical staff counsel parents about the timing of surgery and survival rates.”