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Surgical timing and mortality in nonsevere paediatric congenital heart disease: A EUROlinkCAT cohort analysis across Europe

Damkjær, Mads; Garne, Ester; Loane, Maria; Urhoj, Stine K; Ballardini, Elisa; Cavero-Carbonell, Clara; Coi, Alessio; ... Morris, Joan K; + view all (2025) Surgical timing and mortality in nonsevere paediatric congenital heart disease: A EUROlinkCAT cohort analysis across Europe. Progress in Pediatric Cardiology , Article 101808. 10.1016/j.ppedcard.2024.101808. (In press).

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Abstract

Background: Management and outcomes amongst children with congenital heart defects (CHD) is relatively heterogeneous. Traditionally, the highest-risk conditions and procedures have received most attention, with less focus on outcome for less severe CHDs. Objectives: Evaluate the management of children born with certain less severe CHDs across Europe. Methods: This population-based linkage cohort study included children diagnosed with ventricular septal defect (VSD), atrial septal defect (ASD), pulmonary valve stenosis (PS) and patent arterial duct (PDA) from nine European regions. Data on surgery/intervention and survival from 1995 to the age of 10 years or until the end of 2014 were collected through electronic linkage to mortality and hospital databases. Kaplan-Meier survival estimates and meta-analyses were used to analyse the proportion of children undergoing surgery/intervention and survival rates. Results: The study included 20,608 children with the less severe CHDs. Surgical correction rates for the anomaly within the first year of life varied significantly, particularly for VSD. The median age for initial surgery/intervention was consistent for VSD but varied for other conditions. Most conditions were corrected in a single procedure, except for PS, which required a median of 1.7 (95 % CI; 1.4–2.0) interventions. Postoperative mortality was highest for neonates undergoing VSD surgery/intervention, 8.7 (95 % CI; 4.0–15.8) deaths per 100 surgeries. The overall 5-year survival rate for all conditions was approximately 98 %. Conclusion: There was considerable variation in the management of less severe CHDs across Europe, particularly in the timing of surgical interventions. Despite these differences, the overall 5-year survival rate is comparable and high.

Type: Article
Title: Surgical timing and mortality in nonsevere paediatric congenital heart disease: A EUROlinkCAT cohort analysis across Europe
DOI: 10.1016/j.ppedcard.2024.101808
Publisher version: https://doi.org/10.1016/j.ppedcard.2024.101808
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Congenital heart defects, Paediatric cardiology, Cardiac surgery
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10203162
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