News

Congenital Heart Disease Survival to Age 18 at 89%


 

Major Findings: Survival to adulthood has significantly improved for persons born with congenital heart disease, from 82% in those born in the 1970s to 89% in those born in the 1990s.

Source of Data: Clinical database of 17,044 patients in the congenital heart disease program at Catholic University, Leuven, Belgium.

Disclosures: Dr. Moons had no financial conflicts of interest to report.

ORLANDO — Infants born with a congenital heart disease during 1990–1999 who then underwent care at a tertiary center had an 89% actuarial survival rate to age 18 or older, based on data collected on more than 3,800 patients treated at one Belgium center.

This rate was a significant improvement compared with an 85% survival to adulthood rate for infants with congenital heart disease born during 1980–1989 and managed at the same center, and the 82% survival to age 18 or older in infants born during 1970–1979, Philip Moons, Ph.D., said at the annual scientific sessions of the American Heart Association.

The most recent 89% rate of survival to adulthood also improved over an often-cited 85% rate from the 32nd Bethesda (Md.) Conference in a 2001 publication based on the outcomes of congenital heart disease patients born during the 1980s, Dr. Moons said (J. Am. Coll. Cardiol. 2001;37:1170–5).

The survival data analyzed by Dr. Moons and his associates came from the clinical database of the congenital heart disease program at Catholic University in Leuven, Belgium. The database included 17,044 patients born with gross structural abnormalities of the heart or intrathoracic great vessels with actual or potential functional significance.

The subset of these patients born during 1990–1999 was 23%; 24% were born before 1970, 10% during 1970–1979, 21% during 1980–1989, and 17% born in 2000 or more recently.

The most common congenital diseases for the entire group of 17,000 was ventricular septal defect, in 22%, followed by atrial septal defect in 15%, and pulmonary valve abnormality in 10%. The defects were mild in 48%, moderate in 42%, and complex in 10%.

Among infants born in 1990–1999, mortality from congenital heart disease occurred because of cardiac failure in 56%, postoperative complications in 22%, and perioperative complications in 9%.

In the 1990–1999 subgroup, mortality during follow-up was 99% in patients with mild congenital heart disease, 90% in those with moderate disease, and 59% in patients with a complex abnormality, said Dr. Moons of Catholic University.

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