REPRODUCTION &SURVIVAL POST CARDIAC MALFORMATION REPAIR

In the last 25 years, surgical advances have led to correction of
congenital heart defects (CHD) in children who otherwise would not have
lived to adulthood. This study has two major objectives: 1) to determine
mortality, morbidity (reoperation, arrhythmia, endocarditis), and
disability after repair of CHD, and the major risk factors which predict
these events; and 2) to assess the safety of pregnancy to women with
corrected CHD, and the risk of prematurity and recurrence of CHD in
offspring. This study would create a registry comprised from all Oregon children
undergoing surgical repair of CHD and would study the eight most prevalent
defects: ventricular septal defect(VSD), atrial septal defect(ASD),
pulmonic stenosis(PS), tetralogy of Fallot(TOF), coarctation of the aorta,
aortic stenosis(AS), transposition of the great arteries(TGA), and patent
ductus arteriosus(PDA). This proposal is an extension of an identical
project complied by the investigators for TOF(N=310), VSD(N=217), and
ASD(N=287). 83% of all subjects were successfully followed after a median
of 9 years of observation; more than 20 years of follow-up was achieved in
more than 75 subjects. All cases of surgical correction of PS, AS, TGA, PDA and coarctation
performed in children age 18 or younger in Oregon from 1958 to 1981 will be
added into the registry. Preoperative, operative and postoperative
variables for each patient will be entered into the data base at chart
review. Follow-up for each patient will be by mailed questionnaire,
telephone survey, or use of the National Death Index. Questionnaires will
assess major morbidity, functional status and reproductive status;
reproduction and important events will be confirmed from physician's
records. Follow-up every two years will continue for all members of the
registry including patients with TOF, VSD and ASD to determine intercurrent
events, reproduction or change in functional status. Actuarial analysis and the Cox proportional hazards model will determine
survival, major events and their risk factors. This study will add knowledge of late survival and morbidity to a data base
which lacks this information. Additionally, we will gather some of the
first data regarding pregnancy and outcome after repair of CHD; this is
vitally important as more adults than ever before with CHD are of
child-bearing age.