Outcomes after surgical coronary artery revascularisation in children with congenital heart disease.

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DOI: 10.1136/heartjnl-2017-312652; PMCID: PMC6092219


OBJECTIVE: Surgical coronary revascularisation in children with congenital heart disease (CHD) is a rare event for which limited information is available. In this study, we review the indications and outcomes of surgical coronary revascularisation from the Pediatric Cardiac Care Consortium, a large US-based multicentre registry of interventions for CHD.

METHODS: This is a retrospective cohort study of children (old) with CHD who underwent surgical coronary revascularisation between 1982 and 2011. In-hospital mortality and graft patency data were obtained from the registry. Long-term transplant-free survival through 2014 was achieved for patients with adequate identifiers via linkage with the US National Death Index and the Organ Procurement and Transplantation Network.

RESULTS: Coronary revascularisation was accomplished by bypass grafting (n=72, median age 6.8 years, range 3 days-17.4 years) or other operations (n=65, median age 2.6 years, range 5 days-16.7 years) in 137 patients. Most revascularisations were related to the aortic root (61.3%) or coronary anomalies (27.7%), but 10.9% of them were unrelated to either of them. Twenty in-hospital deaths occurred, 70% of them after urgent 'rescue' revascularisation in association with another operation. Long-term outcomes were available by external linkage for 54 patients surviving to hospital discharge (median follow-up time 15.0 years, max follow-up 29.8 years) with a 15-year transplant-free survival of 91% (95% CI 83% to 99%).

CONCLUSIONS: Surgical coronary revascularisation can be performed in children with CHD with acceptable immediate and long-term survival. Outcomes are dependent on indication, with the highest mortality in rescue procedures.

Journal Title

Heart (British Cardiac Society)





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MeSH Keywords

Adolescent; Child, Preschool; Female; Follow-Up Studies; Heart Defects, Congenital; Hospital Mortality; Humans; Infant, Newborn; Long Term Adverse Effects; Male; Myocardial Revascularization; Outcome and Process Assessment, Health Care; Registries; Retrospective Studies; Survival Analysis; United States


congenital heart disease; congenital heart disease surgery

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