I.G. Lebid, I.M. Yemets. Gender-determined features of surgery-treated and non-treated adults with congenital heart disease

The aim – to estimate effect of gender differences on risk of cardiac and surgical treatment and on follow-up after surgery in adulthood in adults with congenital heart disease (CHD).

Material and methods. Between April 1, 2011 and December 31, 2015, we included 2044 consecutive patients with CHD. For distribution of CHD, there were estimated 11 patient’s groups by nomenclature (more than 40 pts in a group). All patients were divided into groups of surgical/percutaneous intervention and never operated adults with CHD. There were two groups: group 1 – adults after interventions in adulthood (first-time and reoperation), group 2 – adults, without any procedures older than 18 years.

Results. Among 2044 adults with CHD, 1059 (52 %) were males and 985 (48 %) women, the median age 26.23±0.24 (range limits, 18–88) years at the time of inclusion. There were more patients who had surgical/percutaneous intervention (n=1295; 63.4 %), compared to adults without any intervention (n=749; 36.6 %). Overall mortality was 0.34 %. Total seven adults died, including five males (0.47 %) and two women (0.20 %) without significant differences. Female patients had significantly more often arrhythmia history (n=236 women, n=201 male, Р<0.05), significantly higher class of heart failure NYHA > 1 (n=453 women, n=285 men, Р<0.05), which required significantly more often medications (n=660 in women, n=466 in men, Р<0.05). Men smoked more often (n=169 men, n=29 women, Р<0.05). The following CHD were registered significantly more often in women: ASD (n=286), VSD (n=169), PDA (n=106) compared to men (n=145, n=129, n=51, respectively, Р<0.05). On the contrary, men had significantly more often congenital aortic valve malformations (n=318) and coarctation of aorta (n=106), compared to women (n=107, n=59, respectively, Р<0.05). Among patients after cardiac procedures performed during childhood and adulthood, men had significantly more interventions in coarctation of aorta (n=96; 91 %) than women (n=47; 80 %, Р<0.05). Conclusions. Surgery-treated and non-treated adults with congenital heart disease had significant differences regarding risk factors and dominance of separate CHD depending on the gender.

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