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Adult congenital cardiac surgery in Indonesia

Published online by Cambridge University Press:  24 May 2011

Karina V. Wilamarta ,
Yoga Yuniadi ,
Jusuf Rachmat ,
Dicky Fakhri ,
Tarmizi Hakim  and
Maizul Anwar
Karina V. Wilamarta
Affiliation:
Department of Cardiac Surgery, Faculty of Medicine, University of Indonesia, and National Cardiovascular Center Harapan Kita Hospital, Jakarta, Indonesia
Yoga Yuniadi*
Affiliation:
Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, and National Cardiovascular Center Harapan Kita Hospital, Jakarta, Indonesia
Jusuf Rachmat
Affiliation:
Department of Cardiac Surgery, Faculty of Medicine, University of Indonesia, and National Cardiovascular Center Harapan Kita Hospital, Jakarta, Indonesia
Dicky Fakhri
Affiliation:
Department of Cardiac Surgery, Faculty of Medicine, University of Indonesia, and National Cardiovascular Center Harapan Kita Hospital, Jakarta, Indonesia
Tarmizi Hakim
Affiliation:
Department of Cardiac Surgery, Faculty of Medicine, University of Indonesia, and National Cardiovascular Center Harapan Kita Hospital, Jakarta, Indonesia
Maizul Anwar
Affiliation:
Department of Cardiac Surgery, Faculty of Medicine, University of Indonesia, and National Cardiovascular Center Harapan Kita Hospital, Jakarta, Indonesia
*
Correspondence to: Yoga Yuniadi, MD, PhD, National Cardiovascular Center Harapan Kita Hospital, Jl. S Parman Kav 87 Slipi, Jakarta 11420, Indonesia. Tel: +62 215684093 ext 1253; Fax: +62 21 536 52358; E-mail: yogayun@yahoo.com
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Abstract

Background

Successful paediatric cardiac surgery and cardiology treatment has resulted in an increase in the use of surgery as a method of treatment of congenital cardiac disease in adult population. However, late detection and lower socio-economic condition in developing countries might change patients’ characteristics by the time they come for treatment. This study aimed to elaborate the long-term surgical results of adult congenital cardiac disease in Indonesia as a developing country.

Methods and results

We reviewed retrospectively all adult congenital cardiac disease patients with a mean age of 28 years plus or minus 9.5 years, who underwent surgery at National Cardiovascular Center. The types of procedures used were corrective in 338 patients (89.2%), palliative in 10 patients (2.6%), and re-operations in 31 patients (8.2%). The overall hospital mortality rate was 2.6% but as high as 20% with palliative surgery. Post-operative New York Heart Association class III–IV is the only independent predictor of death at 60 months (hazard ratio 61.48, 95% confidence interval 9.41–401.69, p<0.001). The survival rates were 96.3% and 95% for overall and non-atrial septal defect in patients at 60 months, which was highest in corrective procedures (97.6%). The percentage of patients free of re-operation at 5 years’ follow-up was 85.4% and 42.7% at 10 years.

Conclusion

In developing countries, surgical treatment of adult congenital cardiac disease is effective and safe, with an overall survival rate of 96.3% at 60 months. Due to high mortality rate, palliative surgery of a non-atrial septal defect patient is recommended to be discontinued. The independent predictor of mortality was post-operative New York Heart Association functional class III–IV.

Keywords

Grown-up congenital heartlong-term surgical resultsdeveloping country
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 6 , 28 October 2011 , pp. 639 - 645
Copyright
Copyright © Cambridge University Press 2011

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Footnotes

a

Drs K.V. Wilamarta and Y. Yuniadi, had an equal contribution in this study.

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