Congenital heart defects: The patients who die

Aims: To register mortality and causes of death in patients with congenital heart defects (CHDs). Methods: Prospective population-based observational study. Results: 553 infants with CHD (1.1% of live born) were observed for 1 - 22 y ( median 10 7/12 y). Sixty-four died (11.6%), of whom 32 (50%) died during the first 4 wk, and 51 (79.7%) during the first year of life. Of the total neonatal deaths in the population ( 3 per 1000), CHDs occurred in 21.5%. Mortality for children with CHDs was not significantly different between the cohorts born in 1982 - 1991 and 1992 - 2002, for either neonatal deaths or deaths later on ( p>0.05). Out of 170 patients in whom therapeutic procedures ( surgery, catheter interventions) were undertaken, 34 (20%) died. Nine cases (1.6%) died with unrecognized CHDs; seven of these on the first day of life with severe extracardiac malformations. In 50 (78.1%) cases, death was judged to be caused directly or indirectly from the CHD, and in 14 (21.9%) from extracardiac malformations or other conditions. Conclusion: CHDs occur in a substantial number of neonatal deaths. Most deaths are caused by cardiac insufficiency. The mortality rate remained unchanged.