{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T21:50:42Z","timestamp":1789854642259,"version":"4.0.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,5,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Postoperative morbidity is an increasingly important outcome measure of patients who have undergone congenital heart surgery (\n              <jats:styled-content style=\"fixed-case\">CHS<\/jats:styled-content>\n              ). We examined late postoperative morbidity after\n              <jats:styled-content style=\"fixed-case\">CHS<\/jats:styled-content>\n              on the basis of patients\u2019 government\u2010issued medical special reimbursement rights.\n            <\/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              Between 1953 and 2009, 10 635 patients underwent\n              <jats:styled-content style=\"fixed-case\">CHS<\/jats:styled-content>\n              at &lt;15\u00a0years of age in Finland. We excluded early deaths and mental disabilities. Noncyanotic and cyanotic defects were divided into simple and severe groups, respectively. We obtained 4 age\u2010, sex\u2010, birth time\u2013, and hospital district\u2013matched control subjects per patient. The Social Insurance Institution of Finland provided data on all medical special reimbursement rights granted between 1966 and 2012. Follow\u2010up started at the first operation and ended at death, date of emigration, or December 31, 2012. A total of 8623 patients met inclusion criteria. Follow\u2010up was 99.9%. A total of 3750 patients (43%) required special reimbursements rights for a chronic disease. Cardiovascular disease was the most common late morbidity among patients (28%), followed by obstructive pulmonary disease (9%), neurologic disease (3%), and psychiatric disease (2%). Heart failure (simple hazard ratio [HR], 56.3 [95%\n              <jats:styled-content style=\"fixed-case\">CI,<\/jats:styled-content>\n              35.4\u201389.7]; severe HR, 918.0 [95% CI, 228.9\u20133681.7]) and arrhythmia (simple HR, 11.0 [95% CI, 7.1\u201317.0]; severe HR, 248.0 [95% CI, 61.3\u20131002.7]) were the most common cardiovascular morbidities. Hypertension was common among patients with coarctation of the aorta (13%; incidence risk ratio [RR], 8.9; 95%\n              <jats:styled-content style=\"fixed-case\">CI,<\/jats:styled-content>\n              7.5\u201310.7). Psychiatric disease was more common among simple defects, particularly ventricular septal defects.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Chronic cardiac and noncardiac sequelae are common after\n              <jats:styled-content style=\"fixed-case\">CHS<\/jats:styled-content>\n              regardless of the severity of the defect, underscoring the importance of long\u2010term follow\u2010up of all patients after\n              <jats:styled-content style=\"fixed-case\">CHS<\/jats:styled-content>\n              .\n            <\/jats:p>\n          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