Abstract
Retrospective analysis was performed to determine the incidence and risk factors for sudden death after surgery for congenital heart disease (CHD). The records of 7,444 procedures, including 1,660 palliative surgery and 5,784 radical surgery procedures, in 5,806 patients with CHD admitted in National Cardiovascular Center from 1977 to 2001, were examined. Forty-two patients died suddenly after palliative surgery. Thirty-nine of these (92.9%) died within three years of palliative surgery and 35 patients (83.3%) were less than 5 years of age. The main cause of sudden death after palliative surgery was hypoxia. Thirty-five patients (83.3%) had previous systemic-to-pulmonary shunt operations. Fifty-eight patients died suddenly after radical surgery. Age at sudden death varied from two months to the 20's. Sudden death after radical surgery occurred in 3 patients (5.1%) with myocardial infarction, 14 (24.1%) with arrhythmia, 4 (6.9%) with heart failure, and 15 (25.9%) with pulmonary hypertension. While all patients complicated with myocardial infarction or arrhythmia died suddenly within 5 years of radical surgery, some patients with heart failure and pulmonary hypertension died suddenly more than 5 years after radical surgery. Sudden deaths occurred with high frequency after atrial switch operations or the Fontan operation. The risk factors for sudden death after surgery of CHD patients were as follows: hypoxia after palliative surgery, previous systemic-to-pulmonary shunt operations, atrial switch operations and the Fontan operation.
