Surgical Outcomes in Adolescent and Adult Congenital Heart Disease: Key Findings and Implications

Strategic Insights -

Researchers at Paediatric & Congenital Heart Centre in Malaysia conducted a retrospective cohort study to evaluate the clinical characteristics and postoperative outcomes in adolescent and adult congenital heart disease (CHD) patients undergoing cardiac surgery. The study analyzed 569 CHD patients who underwent surgery at a tertiary center between 2018 and 2023. The researchers identified significant postoperative bleeding as the main predictor of major adverse events, with redo sternotomy doubling the risk of postoperative bleeding.

Key Takeaways:

  • The study analyzed 569 CHD patients who underwent surgery at a tertiary center in Malaysia between 2018 and 2023.
  • The median age at surgery was 19.7 years, with 42.4% of patients undergoing redo sternotomy.
  • Complications occurred in 60.1% of patients, with major adverse events (MAEs) in 4.9% and mortality in 2.1%.
  • Multivariate analysis identified significant postoperative bleeding as the main predictor of MAEs, with redo sternotomy doubling the risk of postoperative bleeding.
  • The study found that the prevalence of significant postoperative bleeding was 15.4% compared to 6.7% in patients who did not undergo redo sternotomy.
  • The research suggested that a structured framework could be used to replicate the findings in other resource-limited settings.

Statistics:

  • 569 CHD patients were included in the study.
  • The median age at surgery was 19.7 years.
  • 42.4% of patients underwent redo sternotomy.
  • Complications occurred in 60.1% of patients.
  • Major adverse events (MAEs) occurred in 4.9% of patients.
  • Mortality rate was 2.1%.
  • Prevalence of significant postoperative bleeding was:

+ 15.4% in patients undergoing redo sternotomy.

+ 6.7% in patients not undergoing redo sternotomy.

Sources:

  • Surgical Outcomes in Adolescent and Adult Congenital Heart Disease: Identifying Predictors of Major Adverse Events. Pediatric Cardiology, 2025.
  • Paediatric & Congenital Heart Centre, Institute Jantung, Negara (National Heart Institute), 145, Jalan Tun Razak, 50400, Kuala Lumpur, Malaysia.
  • Springer, One New York Plaza, Suite 4600, New York, Ny, United States (www.springer.com; www.springerlink.com/content/0172-0643/)
  • Health & Medicine Week, October 24, 2025, p 101.