Clinical Study and Risk Factors of Surgical Mortality of Congenital Heart Defects / 대한흉부외과학회지

ABSTRACT

OBJECTIVES: The surgical mortality of congenital heart defects has been reduced for the very young age group. Especially, young age at repair is an important risk factor for mortality after repair of tetralogy of Fallot. Some risk factors were analyzed. METHODS: Three hundred and sixty six patients underwent surgical intervention. Ages ranged from 5 days to 64 years, and 80 patients were adults(over 15 years of age). The defects consisted of 313(84.2%) acyanotic and 53(15.8%) cy anotic anomalies. The surgical mortalities were evaluated by univariate and multivariate analysis. RESULTS: The overall surgical mortality was 10.4%. Most deaths occurred in the infant group younger than 6 months(20/38 deaths) and in cyanotic group(21/38 deaths). Surgical infant mortality younger than 12 months was 24.8%(25/10 1). Risk factors of mortality in open heart surgery were age(p<0.0001), body weight(p<0.0001), pump time(p<0.0001), aortic cross clamp time(p<0.0001), use of total circulatory arrest(p<0.0001) and cyanotic disease(p<0.0001) by univariate analysis. But by multivariate analysis, the risk factor of mortality in open heart surgery was disease entity(p=0.002) only. A disease group with the highest risk was a cyanotic group(odds ratio was 15.3 relative to ventricular septal defect) excluding t etralogy of Fallot(odds ratio=0.27). CONCLUSIONS: Even though the most important risk factor was disease entity, technically feasible factors influencing mortality indicated by univariate analysis should be improved.