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Coronary artery disease screening in adults with congenital heart disease prior to cardiac surgery. Congenit Heart Dis 2019 Nov;14(6):895-900

Date

09/07/2019

Pubmed ID

31489771

DOI

10.1111/chd.12839

Scopus ID

2-s2.0-85071872607   1 Citation

Abstract

OBJECTIVE: As adults with congenital heart disease (CHD) grow older, preoperative screening for coronary artery disease (CAD) may be indicated prior to CHD surgery. Data regarding the indications for preoperative CAD screening in this population are limited. Current practice is to follow guidelines for patients with valvular heart disease; however, the risk for CAD in certain congenital heart diagnoses may be higher than the general population. This study aimed to assess the results of preoperative CAD screening in patients prior to CHD surgery.

DESIGN: Retrospective study.

SETTING: Single tertiary center.

PATIENTS: Patients ≥35 years that had CHD surgery from 1/1/2007 to 5/1/2017.

OUTCOME MEASURES: Data regarding CAD risk factors and preoperative CAD screening results were obtained. Prevalence and risk factors for CAD were analyzed, along with their relationship to perioperative outcomes.

RESULTS: A total of 73 patients underwent CAD screening with either cardiac catheterization (56%) or computed tomography angiography (34%) prior to CHD surgery. Overall 16 (22%) patients were found to have CAD. Only two patients had severe coronary stenosis and underwent coronary bypass grafting at time of CHD surgery. Patients with CAD were more likely to be older and have history of hypertension, dyslipidemia, and tobacco smoking. CHD diagnosis was not significantly associated with presence of CAD.

CONCLUSION: CAD is common in asymptomatic older patients referred for screening prior to CHD surgery; however, severe CAD requiring concomitant coronary intervention is uncommon. Preoperative CAD screening should be based on age and traditional CAD risk factors, rather than underlying CHD.

Author List

Johnson B, Buelow M, Earing M, Cohen S, Bartz P, Ginde S

Authors

Peter J. Bartz MD Professor in the Pediatrics department at Medical College of Wisconsin
Matthew W. Buelow MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Scott B. Cohen MD Associate Professor in the Medicine department at Medical College of Wisconsin
Salil Ginde MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Cardiac Catheterization
Cardiac Surgical Procedures
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Bypass
Coronary Artery Disease
Female
Heart Defects, Congenital
Humans
Male
Middle Aged
Predictive Value of Tests
Prevalence
Retrospective Studies
Risk Factors
Severity of Illness Index
Treatment Outcome
Wisconsin
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a