Key result
Tertiary center management of adult congenital heart disease achieves zero perioperative mortality.
Why the study?
Clinical presentation, management approaches, and short-term outcomes among adults with congenital heart disease in Pakistan were not well characterized.
Cross-Sectional (n=129)
No
In a Pakistani cohort of adults with congenital heart disease, surgical and catheter-based interventions were associated with favorable short-term outcomes and no operative mortality, though postoperative ventricular dysfunction was common.
Objective: To assess the clinical presentation, management approaches, and short-term outcomes among adult patients with congenital heart disease (ACHD) presenting to a tertiary care hospital in Peshawar, Pakistan. Methodology: This cross-sectional study was conducted in the Department of Pediatric Cardiology and Intensive Care Unit (ICU) at Lady Reading Hospital, Peshawar, Pakistan, from March 2025 to November 2025. Patients of either gender, aged 18 years or older, with a confirmed diagnosis of congenital heart disease were included in the study. Data regarding demographic characteristics, clinical presentation, type of congenital heart defect, therapeutic interventions, and clinical outcomes were collected and analyzed. Outcomes were assessed in terms of intra-operative or postoperative mortality and postoperative complications. Results: A total of 129 patients with adult congenital heart disease were included, of whom 68 (52.7%) were male. The median age of the patients was 22.00 years. Ten (7.8%) patients were newly diagnosed with congenital heart disease during the study period. The most frequently observed congenital heart defects were tetralogy of Fallot (TOF), atrial septal defect (ASD), and ventricular septal defect (VSD), accounting for 32 (24.8%), 25 (19.4%), and 22 (17.1%) cases, respectively. The most common presenting complaints were shortness of breath, cyanosis, and palpitations, reported in 120 (93.0%), 48 (37.2%), and 44 (34.1%) patients, respectively. Cardiac catheterization was the most frequently performed intervention, carried out in 41 (31.8%) patients. Total correction, VSD closure, and ASD closure were performed in 9 (7.0%), 7 (5.4%), and 7 (5.4%) patients, respectively. No intra-operative or postoperative mortality was recorded. The most frequently documented postoperative complications were left ventricular dysfunction in 39 (30.2%), right ventricular dysfunction in 23 (17.9%), biventricular dysfunction in 6 (4.7%), and ventricular hypertrophy in 3 (2.3%) patients. Conclusion: Tetralogy of Fallot, atrial septal defect, and ventricular septal defect were the most commonly encountered congenital heart diseases among adults in this study. A considerable proportion of patients required surgical or catheter-based interventions. Despite the complexity of the underlying cardiac conditions, favorable short-term outcomes were observed, with no intra-operative or postoperative mortality reported.
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Dr. Jawad Ahmad Author Dr. Rani Aqsa Islam Author Sartaj Ali Author Zia Ur Rahman Author Ghulam Murtaza Author Shariq Amin Author Aitazaz Rafi Author Shoukat Ali* (2026) conducted a cross-sectional in Adult congenital heart disease (n=129). Tertiary care management for adult congenital heart disease was evaluated on Intra-operative or postoperative mortality and postoperative complications. Among adults with congenital heart disease, tetralogy of Fallot was the most common defect (24.8%), and management at a tertiary center yielded 0% intra-operative or postoperative mortality.
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