{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:03:22Z","timestamp":1787069002773,"version":"build-2736575974"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,11,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Prior research has focused on early outcomes after congenital heart surgery, but less is known about later risks. We aimed to determine the late causes of death among children (&lt;21\u00a0years of age) surviving their initial congenital heart surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This is a retrospective cohort study from the Pediatric Cardiac Care Consortium, a US\u2010based registry of interventions for congenital heart defects (CHD). Excluding patients with chromosomal anomalies or inadequate identifiers, we matched those surviving their first congenital heart surgery (1982\u20132003) against the National Death Index through 2014. Causes of death were obtained from the National Death Index to calculate cause\u2010specific standardized mortality ratios (SMRs). Among 31\u00a0132 patients, 2527 deaths (8.1%) occurred over a median follow\u2010up period of 18\u00a0years. Causes of death varied by time after surgery and severity of CHD but, overall, 69.9% of deaths were attributed to the CHD or another cardiovascular disorder, with a SMR for CHD\/cardiovascular disorder of 67.7 (95% confidence interval: 64.5\u201370.8). Adjusted odds ratios revealed increased risk of death from CHD\/cardiovascular disorder in females [odds ratio=1.28; 95% confidence interval (1.04\u20131.58);\n                      <jats:italic>P<\/jats:italic>\n                      =0.018] with leading cardiovascular disorder contributing to death being cardiac arrest (16.8%), heart failure (14.8%), and arrhythmias (9.1%). Other major causes of death included coexisting congenital malformations (4.7%, SMR: 7.0), respiratory diseases (3.6%, SMR: 8.2), infections (3.4%, SMR: 8.2), and neoplasms (2.1%, SMR: 1.9).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Survivors of congenital heart surgery face long\u2010term risks of premature mortality mostly related to residual CHD pathology, heart failure, and arrhythmias, but also to other noncardiac conditions. Ongoing monitoring is warranted to identify target factors to address residual morbidities and improve long\u2010term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.118.010624","type":"journal-article","created":{"date-parts":[[2018,12,16]],"date-time":"2018-12-16T15:51:29Z","timestamp":1544975489000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":65,"title":["Mortality Following Pediatric Congenital Heart Surgery: An Analysis of the Causes of Death Derived From the National Death Index"],"prefix":"10.1161","volume":"7","author":[{"given":"Courtney","family":"McCracken","sequence":"first","affiliation":[{"name":"Children's Healthcare of Atlanta Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan G.","family":"Spector","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Minnesota Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah S.","family":"Menk","sequence":"additional","affiliation":[{"name":"Biostatistical Design and Analysis Center University of Minnesota Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica H.","family":"Knight","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of Georgia School of Public Health Athens GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Vinocur","sequence":"additional","affiliation":[{"name":"Department of Pediatrics School of Medicine and Dentistry University of Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda S.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"Oster","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"St Louis","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery University of Missouri\u2010Kansas City School of Medicine Kansas City MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"Moller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Minnesota Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazaros","family":"Kochilas","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.012033"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.587"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.011190"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.491"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.964841"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.05.040"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01169-3"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.038"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.09.015"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.09.023"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.05.009"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.02.133"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.003076"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.734921"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.10.060"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.065"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.011241"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000017557.24261.A7"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.08.057"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3863"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029138"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019137"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.05.014"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.06.042"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.11.065"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.963603"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.179568"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.062"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-013-0633-4"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003783"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.491"},{"key":"e_1_3_2_33_2","unstructured":"Bilgrad R National Center for Health Statistics. National death index plus: coded causes of death: supplement to the national death index user's manual. Hyattsville MD: Division of Vital Statistics National Center for Health Statistics Centers for Disease Control and Prevention;1999."},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023889"},{"key":"e_1_3_2_35_2","unstructured":"Centers for Disease Control and Prevention National Center for Health Statistics . Compressed Mortality File 1999\u20132015 on CDC WONDER Online Database released December 2016. Data are from the Compressed Mortality File 1999\u20102015 Series 20 No. 2U 2016 as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Available at: http:\/\/wonder.cdc.gov\/cmf-icd10.html. Accessed June 5 2017."},{"key":"e_1_3_2_36_2","unstructured":"Collaborative data science. Plotly Technologies Inc. Montr\u00e9al QC 2015. https:\/\/plot.ly."},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000608"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1140"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezx107"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.126755"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.08.051"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1998.662"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl014"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029138"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2014.12.002"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017202"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.06.060"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00187-9"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.08.014"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.03.071"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(00)00177-0"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.118.010624","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:48:26Z","timestamp":1715586506000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.118.010624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,20]]},"references-count":50,"journal-issue":{"issue":"22","published-print":{"date-parts":[[2018,11,20]]}},"alternative-id":["10.1161\/JAHA.118.010624"],"URL":"https:\/\/doi.org\/10.1161\/jaha.118.010624","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,20]]},"assertion":[{"value":"2018-08-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e010624"}}