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, arrhythmias, 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 of 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). 87% of all subjects were successfully followed with a median of 9 years of observation; more than 85 subjects have been followed for more than 20 years. 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 to the registry. Preoperative, operative and postoperative data for each patient will be entered into the data base at chart review. Follow-up for each patient will be gathered by mailed questionnaire, telephone survey, and the National Death Index. Questionnaires will assess major morbidity, functional status and reproduction; pregnancy and major events will be confirmed from physician's records. Follow-up for TOF, VSD and ASD will be conducted in years 1, 3 and 5 and for TGA, AS, PS, PDA and coarctation in years 2 and 4. Chart review will be completed in year 2, and cases will then be prospectively identified. Actuarial analysis and the Cox proportional hazards model will determine mortality, major morbidity and their risk factors. Reproductive data will be analyzed per years of fertility for the cohort, and compared to Oregon population statistics. This study will add knowledge of late survival and morbidity of a population which is rapidly growing in size, adults with corrected CHD. Additionally, we will gather the first prospective population data on pregnancy and outcome after repair of CHD; this is vital as more adults than ever before with CHD are of child-bearing age.
| Reller, M D; Morris, C D (1998) Is Down syndrome a risk factor for poor outcome after repair of congenital heart defects? J Pediatr 132:738-41 |
| Morris, C D; Reller, M D; Menashe, V D (1998) Thirty-year incidence of infective endocarditis after surgery for congenital heart defect. JAMA 279:599-603 |
| Morris, C D; Menashe, V D (1991) 25-year mortality after surgical repair of congenital heart defect in childhood. A population-based cohort study. JAMA 266:3447-52 |
| Morris, C D; Outcalt, J; Menashe, V D (1990) Hypoplastic left heart syndrome: natural history in a geographically defined population. Pediatrics 85:977-83 |
