Advertisement

Cardiac Surgical Challenges in Adults with Congenital Heart Disease

  • Arman Arghami
  • Joseph A. Dearani
  • M. Sertaç Çiçek
  • Sameh M. Said
Chapter
Part of the Congenital Heart Disease in Adolescents and Adults book series (CHDAA)

Abstract

This chapter will review the issues that go through a surgeon’s mind when preparing and carefully planning either a primary or repeat operation for adult patients with congenital heart disease. The importance of collaboration between surgeons, anesthesiologists, cardiologists, critical care specialists, radiologists, other physician subspecialists, and other allied healthcare personnel cannot be overemphasized.

References

  1. 1.
    Hoffman JI, Kaplan S, Liberthson RR. Prevalence of congenital heart disease. Am Heart J. 2004;147(3):425–39.CrossRefGoogle Scholar
  2. 2.
    Kouchoukos NT, Kirklin JW. Kirklin/Barratt-Boyes cardiac surgery: morphology, diagnostic criteria, natural history, techniques, results, and indications. Philadelphia, PA: Elsevier/Saunders; 2013. https://www.clinicalkey.com/dura/browse/bookChapter/3-s2.0-C20091575843.Google Scholar
  3. 3.
    Warnes CA, Liberthson R, Danielson GK, Dore A, Harris L, Hoffman JI, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol. 2001;37(5):1170–5.CrossRefGoogle Scholar
  4. 4.
    Karamlou T, Diggs BS, Person T, Ungerleider RM, Welke KF. National practice patterns for management of adult congenital heart disease: operation by pediatric heart surgeons decreases in-hospital death. Circulation. 2008;118(23):2345–52.CrossRefGoogle Scholar
  5. 5.
    Anwar S, Singh GK, Varughese J, Nguyen H, Billadello JJ, Sheybani EF, et al. 3D printing in complex congenital heart disease: across a spectrum of age, pathology, and imaging techniques. JACC Cardiovasc Imaging. 2017;10(8):953–6.CrossRefGoogle Scholar
  6. 6.
    Landzberg MJ. Catheterization of the adult with congenital heart disease (ACHD): beyond “shooting the coronaries”. J Interv Cardiol. 2001;14(3):329–37.CrossRefGoogle Scholar
  7. 7.
    Koifman B, Egdell R, Somerville J. Prevalence of asymptomatic coronary arterial abnormalities detected by angiography in grown-up patients with congenital heart disease. Cardiol Young. 2001;11(6):614–8.CrossRefGoogle Scholar
  8. 8.
    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). Developed in collaboration with the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(23):e143–263.CrossRefGoogle Scholar
  9. 9.
    Therrien J, Dore A, Gersony W, Iserin L, Liberthson R, Meijboom F, et al. CCS consensus conference 2001 update: recommendations for the management of adults with congenital heart disease. Part I. Can J Cardiol. 2001;17(9):940–59.PubMedGoogle Scholar
  10. 10.
    Holst KA, Said SM, Nelson TJ, Cannon BC, Dearani JA. Current interventional and surgical management of congenital heart disease: specific focus on valvular disease and cardiac arrhythmias. Circ Res. 2017;120(6):1027–44.CrossRefGoogle Scholar
  11. 11.
    Said SM, Dearani JA. Strategies for high-risk reoperations in congenital heart disease. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2014;17(1):9–21.CrossRefGoogle Scholar
  12. 12.
    Kirklin JK, Westaby S, Blackstone EH, Kirklin JW, Chenoweth DE, Pacifico AD. Complement and the damaging effects of cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1983;86(6):845–57.PubMedGoogle Scholar
  13. 13.
    Akl BF, Pett SB Jr, Wernly JA. Use of a sagittal oscillating saw for repeat sternotomy: a safer and simpler technique. Ann Thorac Surg. 1984;38(6):646–7.CrossRefGoogle Scholar
  14. 14.
    Holst KA, Dearani JA, Burkhart HM, Connolly HM, Warnes CA, Li Z, et al. Risk factors and early outcomes of multiple reoperations in adults with congenital heart disease. Ann Thorac Surg. 2011;92(1):122–8; discussion 9–30.CrossRefGoogle Scholar
  15. 15.
    Vida VL, Berggren H, Brawn WJ, Daenen W, Di Carlo D, Di Donato R, et al. Risk of surgery for congenital heart disease in the adult: a multicentered European study. Ann Thorac Surg. 2007;83(1):161–8.CrossRefGoogle Scholar
  16. 16.
    Kogon B, Grudziak J, Sahu A, Jokhadar M, McConnell M, Book W, et al. Surgery in adults with congenital heart disease: risk factors for morbidity and mortality. Ann Thorac Surg. 2013;95(4):1377–82; discussion 82.CrossRefGoogle Scholar
  17. 17.
    Attenhofer Jost CH, Connolly HM, Scott CG, Burkhart HM, Ammash NM, Dearani JA. Increased risk of possible paradoxical embolic events in adults with Ebstein anomaly and severe tricuspid regurgitation. Congenit Heart Dis. 2014;9(1):30–7.CrossRefGoogle Scholar
  18. 18.
    Celermajer DS, Bull C, Till JA, Cullen S, Vassillikos VP, Sullivan ID, et al. Ebstein's anomaly: presentation and outcome from fetus to adult. J Am Coll Cardiol. 1994;23(1):170–6.CrossRefGoogle Scholar
  19. 19.
    Attie F, Rosas M, Rijlaarsdam M, Buendia A, Zabal C, Kuri J, et al. The adult patient with Ebstein anomaly. Outcome in 72 unoperated patients. Medicine (Baltimore). 2000;79(1):27–36.CrossRefGoogle Scholar
  20. 20.
    Brown ML, Dearani JA, Danielson GK, Cetta F, Connolly HM, Warnes CA, et al. The outcomes of operations for 539 patients with Ebstein anomaly. J Thorac Cardiovasc Surg. 2008;135(5):1120–36, e1–7.CrossRefGoogle Scholar
  21. 21.
    Dearani JA, Said SM, Burkhart HM, Pike RB, O'Leary PW, Cetta F. Strategies for tricuspid re-repair in Ebstein malformation using the cone technique. Ann Thorac Surg. 2013;96(1):202–8; discussion 8–10.CrossRefGoogle Scholar
  22. 22.
    Hebe J. Ebstein's anomaly in adults. Arrhythmias: diagnosis and therapeutic approach. Thorac Cardiovasc Surg. 2000;48(4):214–9.CrossRefGoogle Scholar
  23. 23.
    Poterucha JT, Anavekar NS, Egbe AC, Julsrud PR, Connolly HM, Ammash NM, et al. Survival and outcomes of patients with unoperated single ventricle. Heart. 2016;102(3):216–22.CrossRefGoogle Scholar
  24. 24.
    Fontan F, Baudet E. Surgical repair of tricuspid atresia. Thorax. 1971;26(3):240–8.CrossRefGoogle Scholar
  25. 25.
    de Leval MR, Kilner P, Gewillig M, Bull C. Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations. Experimental studies and early clinical experience. J Thorac Cardiovasc Surg. 1988;96(5):682–95.PubMedGoogle Scholar
  26. 26.
    Marcelletti C, Corno A, Giannico S, Marino B. Inferior vena cava-pulmonary artery extracardiac conduit. A new form of right heart bypass. J Thorac Cardiovasc Surg. 1990;100(2):228–32.PubMedGoogle Scholar
  27. 27.
    Khairy P, Fernandes SM, Mayer JE Jr, Triedman JK, Walsh EP, Lock JE, et al. Long-term survival, modes of death, and predictors of mortality in patients with Fontan surgery. Circulation. 2008;117(1):85–92.CrossRefGoogle Scholar
  28. 28.
    Gelatt M, Hamilton RM, McCrindle BW, Gow RM, Williams WG, Trusler GA, et al. Risk factors for atrial tachyarrhythmias after the Fontan operation. J Am Coll Cardiol. 1994;24(7):1735–41.CrossRefGoogle Scholar
  29. 29.
    Kao JM, Alejos JC, Grant PW, Williams RG, Shannon KM, Laks H. Conversion of atriopulmonary to cavopulmonary anastomosis in management of late arrhythmias and atrial thrombosis. Ann Thorac Surg. 1994;58(5):1510–4.CrossRefGoogle Scholar
  30. 30.
    Backer CL, Deal BJ, Mavroudis C, Franklin WH, Stewart RD. Conversion of the failed Fontan circulation. Cardiol Young. 2006;16(Suppl 1):85–91.CrossRefGoogle Scholar
  31. 31.
    Said SM, Burkhart HM, Schaff HV, Cetta F, Driscoll DJ, Li Z, et al. Fontan conversion: identifying the high-risk patient. Ann Thorac Surg. 2014;97(6):2115–21; discussion 21–2.CrossRefGoogle Scholar
  32. 32.
    Wu FM, Kogon B, Earing MG, Aboulhosn JA, Broberg CS, John AS, et al. Liver health in adults with Fontan circulation: a multicenter cross-sectional study. J Thorac Cardiovasc Surg. 2017;153(3):656–64.CrossRefGoogle Scholar
  33. 33.
    Asrani SK, Warnes CA, Kamath PS. Hepatocellular carcinoma after the Fontan procedure. N Engl J Med. 2013;368(18):1756–7.CrossRefGoogle Scholar
  34. 34.
    Saremi F, SpringerLink (online service). Cardiac CT and MR for adult congenital heart disease. Available from:  https://doi.org/10.1007/978-1-4614-8875-0.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Arman Arghami
    • 1
  • Joseph A. Dearani
    • 1
  • M. Sertaç Çiçek
    • 1
  • Sameh M. Said
    • 1
  1. 1.Department of Cardiovascular SurgeryMayo ClinicRochesterUSA

Personalised recommendations