Congenital heart disease patients are at highest risk of right-sided complications after cardiac surgery, regardless the side of surgery

Background: Cardiac surgery relieves symptoms and increases life expectancy in cardiac patients. However, cardiac surgery has risks of complications.

Methods: Adults with congenital (CHD) operated between January 2001 and January 2011 in the Academic Medical Center in Amsterdam were studied. Prevalence of complications in patients with CHD was compared to literature estimates in patients with acquired heart disease (AHD). Data of 412 age and sex matched AHD patients will be available soon.

Results: Data of 412 consecutive CHD patients (age 36 ± 14 years) were studied. Right-sided surgery was performed 122 (30%), left-sided surgery 160 (39%) and both-sided surgery 130 times (31%) times. Patients with CHD suffered more frequently from right ventricular failure (4.4 versus 2%; p < 0.02), pulmonary hypertension (2.4 versus 0.1%; p < 0.01), atelectasis (51.5 versus 30.0%; p <0.01) and pleura effusions (55.8 versus 24.0%; p < 0.01) than patients with AHD. However, patients with CHD suffered less frequently from atrial fibrillation (14.0 versus 51%; p < 0.01), acute coronary syndrome (0.7 versus 3.2%; p < 0.01), acute kidney injury (3.4 versus 7.9%; p < 0.01) and stroke (0.1 versus 2.4%; p < 0.01).

Conclusion: Patients with CHD have more frequent right ventricular failure, pulmonary hypertension, atelectasis and pleura effusions after cardiac surgery than patients with AHD, regardless the side of surgery.