Objective To summarize the clinical outcome and strategy of re-operation on adult and older children patients with congenital heart disease.
Methods We retrospectively analyzed the clinical data of 339 patients underwent re-operation in our hospital from January 2010 to December 2014. There were 214 males and 125 females at the mean age of 21.6±12.4 years. According to the pathophysiological result and the difficulty level of operation, patients were divided into a simple re-operation group (n=186) and a complex re-operation group (n=153) . We compared the clinical outcomes of two groups.
Results In the simple re-operation group, the rate of mortality was zero and the rate of complications was 5.9%. There was 1 patient of interoperative right atrium injury, 1 patient of extensive hemorrhage, 5 patients of postoperative secondary thoracotomy, 1 patient of hemodialysis, 3 patients of severe infection, and 2 patients of Ⅲ degree atrioventricular blockage. In the complex re-operation group, the rate of mortality was 3.3% and the rate of complication was 30.1%. There were 2 patients of intraoperative coronary artery lesion, 2 patients of aortic injury, 1 patient of pulmonary artery injury, 6 patients of extensive bleeding, 8 patients of postoperative secondary thoracotomy, 13 patients of hemodialysis, 12 patients of severe infection, 5 patients of nervous system complications, 4 patients of Ⅲ degree atrioventricular blockage. Extracorporeal membrane oxygenation (ECMO) applied in 4 patients.
Conciusion Complex re-operation is still the influential factor of mortality and complications for patients with congenital heart disease and we should take measures to aviod the mortality and complications.
