Perfil clínico-quirúrgico de adultos con cardiopatía congénita operados en un centro de referencia peruano

Rosina Ruiz Roque; Carlos Carcausto Huamani; Ruht Villarroel Villa; Corina Céspedes Solano; Miriam Gaby Escate; Jorge Quispe López; Reynaldo Saire Huamán; Ángel Alejos Alarcón; Jenny Cedrón Custodio; Julia Vásquez Quispe; Betthina Avalos Carasas; Edwar Paul Cachay; Adriel Olórtegui Yzú; Víctor Justo Robles Velarde; Marina Huamán Robles

doi:10.47487/apcyccv.v7i2.597

Authors

Rosina Ruiz Roque Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0000-0001-5605-8605
Carlos Carcausto Huamani Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0009-0005-4163-2383
Ruht Villarroel Villa Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0000-0001-5092-1113
Corina Céspedes Solano Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0009-0003-1015-4900
Miriam Gaby Escate Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0009-0002-7238-056X
Jorge Quispe López Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0009-0001-3873-5526
Reynaldo Saire Huamán Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0000-0002-7841-8795
Ángel Alejos Alarcón Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0009-0008-1025-9776
Jenny Cedrón Custodio Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0009-0003-2491-7518
Julia Vásquez Quispe Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0009-0003-2491-7518
Betthina Avalos Carasas Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0009-0000-7801-5163
Edwar Paul Cachay Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0000-0001-6407-3872
Adriel Olórtegui Yzú Instituto Nacional Cardiovascular, Lima, Perú.
Víctor Justo Robles Velarde Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0000-0002-7610-3722
Marina Huamán Robles Instituto Nacional Cardiovascular, Lima, Perú. https://orcid.org/0000-0002-0670-4143

DOI:

https://doi.org/10.47487/apcyccv.v7i2.597

Keywords:

Heart Defects, Congenital, Adult, Cardiac Surgical Procedures, Treatment Outcome, Peru

Abstract

Objective: To describe the clinical and surgical profile and postoperative outcomes of adults with congenital heart disease undergoing cardiac surgery at a national referral center in Peru. Materials and Methods: An observational, retrospective, descriptive study was conducted among adults with congenital heart disease who underwent cardiac surgery at a referral center in Perú between May 2022 and July 2025. Diagnoses and surgical procedures were classified according to the Society of Thoracic Surgeons (STS) anatomic categories, and perioperative risk was stratified using the PEACH (PErioperative ACHd Score). Results: A total of 117 patients were included, with a mean age of 40 ± 13.8 years; 70.1% were women. Most patients were classified as NYHA functional class II (74.4%), and the predominant diagnosis was septal defects (53.8%), mainly atrial septal defect (46.2%). According to the PEACH Score, 61.5% were categorized as low surgical risk. Primary surgeries accounted for 90.6% of cases; 88.0% of patients required multiple surgical corrections during the same procedure; cardiopulmonary bypass was used in 97.4% of cases. Postoperative mechanical ventilation time had a median of 19.4 hours (IQR: 13.0–25.3), with early extubation (6–24 hours) observed in 62.4% of patients. Prolonged intensive care unit stay (>7 days) occurred in 58.1% of cases. Arrhythmias were the most frequent postoperative complication (31.6%), mainly atrial fibrillation (12 %) and atrial flutter (9.4%). In-hospital mortality was 0.9%. Conclusions: Adults with congenital heart disease undergoing cardiac surgery showed low in-hospital mortality.

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References

Nasr VG, Kussman BD. Advances in the Care of Adults With Congenital Heart Disease. Semin Cardiothorac Vasc Anesth. septiembre de 2015;19(3):175-86. doi:10.1177/1089253214563989 PubMed PMID: 25542866.

Mongeon FP, Ben Ali W, Khairy P, Bouhout I, Therrien J, Wald RM, et al. Pulmonary Valve Replacement for Pulmonary Regurgitation in Adults With Tetralogy of Fallot: A Meta-analysis-A Report for the Writing Committee of the 2019 Update of the Canadian Cardiovascular Society Guidelines for the Management of Adults With Congenital Heart Disease. Can J Cardiol. diciembre de 2019;35(12):1772-83. doi:10.1016/j.cjca.2019.08.031 PubMed PMID: 31813508.

Rodriguez FH, Marelli AJ. The epidemiology of heart failure in adults with congenital heart disease. Heart Fail Clin. enero de 2014;10(1):1-7. doi:10.1016/j.hfc.2013.09.008 PubMed PMID: 24275290.

Afilalo J, Therrien J, Pilote L, Ionescu-Ittu R, Martucci G, Marelli AJ. Geriatric congenital heart disease: burden of disease and predictors of mortality. J Am Coll Cardiol. 27 de septiembre de 2011;58(14):1509-15. doi:10.1016/j.jacc.2011.06.041 PubMed PMID: 21939837.

de Hosson M, De Backer J, De Wolf D, De Groote K, Demulier L, Mels S, et al. Development of a transition program for adolescents with congenital heart disease. Eur J Pediatr. febrero de 2020;179(2):339-48. doi:10.1007/s00431-019-03515-4 PubMed PMID: 31758312.

Thakkar A, Fuentes-Rojas S, Karanja E, Ebunlomo E, Millette A, Lee CH, et al. Building an Adult Congenital Heart Program: Critical Components and Important Allies. Curr Cardiol Rep. 11 de octubre de 2018;20(12):134. doi:10.1007/s11886-018-1080-x PubMed PMID: 30311002; PubMed Central PMCID: PMC6267382.

Robles MH, Kim SY, Villa RV, Bernier R, Huamaní CC, Méndez AM, et al. Implementación y adaptación de la nomenclatura estandarizada de la Society of Thoracic Surgeons para cirugía cardíaca congénita en un hospital del Perú. Arch Peru Cardiol Cir Cardiovasc. 24 de septiembre de 2025;6(3):135-43. doi:10.47487/ apcyccv.v6i3.489

Robles-Velarde V. La cardiopatía congénita del adulto: un desafío de salud del presente y del futuro. Arch Peru Cardiol Cir Cardiovasc. 1(3):135-8. doi:10.47487/apcyccv.v1i3.73 PubMed PMID: 38090205; PubMed Central PMCID: PMC10712228.

Mughal AR, Tousif R, Alamgir AR, Jalal A. Pattern of un-operated Grown Up Congenital Heart (GUCH) patients presenting to a Tertiary Care Cardiac Institute of Punjab. Pak J Med Sci. 2019;35(4):1066-71. doi:10.12669/pjms.35.4.878 PubMed PMID: 31372144; PubMed Central PMCID: PMC6659084.

Constantine A, Costola G, Bianchi P, Chessa M. et al. Enhanced Assessment of Perioperative Mortality Risk in Adults With Congenital Heart Disease. J Am Coll Cardiol. 2021. doi:10.1016/j. jacc.2021.04.096

Society of Thoracic Surgeons. Congenital Heart Surgery Database Data Specifications Version 3.41 [Internet]. Chicago (IL): STS; 2020 [citado 12 de diciembre 2025]. Disponible en: https://www.sts. org/sites/default/files/documents/CongenitalDataSpecsV3_41. pdf.

Lim JCES, Elliott MJ, Wallwork J, Keogh B. Cardiac surgery and congenital heart disease: reflections on a modern revolution. Heart Br Card Soc. mayo de 2022;108(10):787-93. doi:10.1136/ heartjnl-2021-320148 PubMed PMID: 35459729.

Bredy C, Ministeri M, Kempny A, Alonso-Gonzalez R, Swan L, Uebing A, et al. New York Heart Association (NYHA) classification in adults with congenital heart disease: relation to objective measures of exercise and outcome. Eur Heart J Qual Care Clin Outcomes. 1 de enero de 2018;4(1):51-8. doi:10.1093/ehjqcco/ qcx031 PubMed PMID: 28950356.

Taylor-Fishwick J, Duarte V, Olson KE, Jacobsen RM, Kay J, Khanna A, et al. Validation of the Perioperative Mortality Risk in Adults with Congenital Heart Disease (PEACH) Score in a US Cohort. Pediatr Cardiol. marzo de 2026;47(3):1183-90. doi:10.1007/ s00246-025-03891-9 PubMed PMID: 40335767.

Mylotte D, Pilote L, Ionescu-Ittu R, Abrahamowicz M, Khairy P, Therrien J, et al. Specialized adult congenital heart disease care: the impact of policy on mortality. Circulation. 6 de mayo de 2014;129(18):1804-12. doi:10.1161/ CIRCULATIONAHA.113.005817 PubMed PMID: 24589851.

Jacobs JP, Mayer JE, Pasquali SK, Hill KD, Overman DM, St Louis JD, et al. The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2019 Update on Outcomes and Quality. Ann Thorac Surg. marzo de 2019;107(3):691-704. doi:10.1016/j. athoracsur.2018.12.016 PubMed PMID: 30641069.

Abarbanell GL, Goldberg CS, Devaney EJ, Ohye RG, Bove EL, Charpie JR. Early surgical morbidity and mortality in adults with congenital heart disease: the University of Michigan experience. Congenit Heart Dis. 2008;3(2):82-9. doi:10.1111/j.1747- 0803.2008.00170.x PubMed PMID: 18380757.

Mazza GA, Gribaudo E, Agnoletti G. The pathophysiology and complications of Fontan circulation. Acta Bio-Medica Atenei Parm. 3 de noviembre de 2021;92(5):e2021260. doi:10.23750/ abm.v92i5.10893 PubMed PMID: 34738582; PubMed Central PMCID: PMC8689331.

Bonanni F, Servoli C, Spaziani G, Bennati E, Di Filippo C, Cirri GK, et al. Congenital Heart Disease After Mid-Age: From the “Grown-Up” to the Elderly. Diagnostics. enero de 2025;15(4):481. doi:10.3390/ diagnostics15040481

Harada M, Motoki H, Kuwahara K. Transitional Care for Adult Patients with Congenital Heart Disease. Intern Med Tokyo Jpn. 15 de febrero de 2025;64(4):483-91. doi:10.2169/ internalmedicine.4264-24 PubMed PMID: 39111880; PubMed Central PMCID: PMC11904460.

Abouelella RS, Habib EA, AlHalees ZY, Alanazi MN, Ibhais ME, Alwadai AH. Outcome of cardiac surgery in adults with congenital heart disease: A single center experience. J Saudi Heart Assoc. julio de 2019;31(3):145-50. doi:10.1016/j.jsha.2019.05.003 PubMed PMID: 31198399; PubMed Central PMCID: PMC6556753.