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Congenital heart disease in adults: surgical management.

Fifty patients between 17 and 62 years of age who had been operated on in the past five years were reviewed. Of 24 patients with atrial septal defects, pulmonary hypertension and dysarrhythmia, which occurred more frequently in the older patients, contributed to marked disability in 54 percent and congestive heart failure in 25 percent. Correction carried minimal risk. All seven patients with coarctation of the aorta were previously hypertensive, and two remain moderately hypertensive after repair. Three patients with Ebstein anomaly were severely disabled but have improved after plastic repairs, although mild tricuspid insufficiency persists. The eight patients with ventricular septal defect were asymptomatic, but the rest, treated for tetralogy, pulmonic stenosis, patent ductus arteriosus, and coronary artery fistula, were moderately symptomatic. Clinical improvement has been achieved and sustained in all patients following repair. The results confirm that congenital heart malformations can be corrected with a good outcome in adults.