Clinical, Demographic, and Socioeconomic Profile of Adults With Congenital Heart Disease at a Reference Center in Salvador, Bahia

Costa, Anabel Goes; Ribeiro, Nilzo Augusto Mendes; Dourado, Adriano Dias; Duarte, Maria Lucia; Ladeia, Ana Marice

doi:10.36660/ijcs.20240161

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Sumário

Original Article • Int J Cardiovasc Sci 39 • 2026 • https://doi.org/10.36660/ijcs.20240161 linkcopy

Clinical, Demographic, and Socioeconomic Profile of Adults With Congenital Heart Disease at a Reference Center in Salvador, Bahia

Authorship SCIMAGO INSTITUTIONS RANKINGS

Background: Congenital heart disease (CHD) in adults has become an area of growing interest in cardiology due to the increased survival of these patients.

Objective: to describe the clinical, demographic, and socioeconomic profile of adults with CHD.

Methods: Cross-sectional study with 371 patients over 18 years of age, followed up at the adult CHD outpatient clinic of Santa Izabel Hospital. A questionnaire was applied to collect demographic and socioeconomic data, and a form with clinical aspects was completed. The chi-square test was used to compare frequencies between groups, with a significance level of p < 0.05.

Results: Mean age was 30 ± 10 years, 188 (50.6%) women, brown race (61.0%), 216 (73.2%) single, 72 employed patients (24.6%). In this study, 249 patients (67.1%) were acyanotic, 138 (55.4%) showed a hyperflow, 90 (24.3%) had tetralogy of Fallot (T4F), 49 (13.2%) had ostium secundum atrial septal defect (ASD), and 30 (8.1%) had ventricular septal defect (VSD). Median age upon surgery was 8.2 years. Patients were classified as: surgically corrected, 194 (52.8%); surgically cured, 89 (24.2%); awaiting surgery, 8 (2.1%); clinical, 36 (9.8%); inoperable, 22 (6.0%); and surgically palliated, 19 (2.1%). Most were in New York Heart Association (NYHA) functional class I (64.5%). Among women, 50 (72.5%) were pregnant, with a neonatal morbidity and mortality rate of 14.0%. Pulmonary hypertension occurred in 17(4.6%) of the patients.

Conclusion: Our study found a predominant population in the third decade of life, with late surgical correction, good clinical evolution related to the benign nature of the pathologies, and greater survival of surgically cured or corrected cases.

Keywords:
Congenital Heart Defects; Adult; Socioeconomic Factors

Variables	N	%
	N = 371
Age (years)	Média ± DP
	30 ± 10
Sex
Male	183	49.3
Female	188	50.6
Marital Status	N = 295
With Partner	79	26.8
Without Partner	216	73.2
Educational Level
Illiterate/Incomplete Elementary Education	97	32.9
Complete Elementary Education	71	24.0
Complete High School	119	40.3
Complete Higher Education	8	2.7
Current Occupation	N = 292
Employed	72	24.6
Students	29	9.9
Retired or Pensioner	74	25.3
Unemployed	89	30.5
Domestic Worker	28	9.6
Ethnicity	N = 290
Brown	177	61.0
Black	90	31.0
White	23	8.0
Social Class	N = 275
B2	8	2.9
C	110	40.0
D	145	52.7
E	11	4.0

Types of heart disease	N	%
T4F	90	24.3
OS ASD	49	13.2
VSD	19	5.1
Coarctation of the Aorta	18	4.9
PVS	16	4.3
PDA	13	3.5
VSD PM Without Repercussion	11	3.0
Partial PM AVSD Type OP ASD	9	2.4
Ebstein's anomaly	8	2.2
Moderate to Significant PVS	8	2.2
TA IB	7	1.9
VSD + Subaortic Membrane	7	1.9
VSD + Aortic Insufficiency	7	1.9
Total AVSD	7	1.9
d-TGA	7	1.9
SV ASD	6	1.6
VSD + Fixed PH	5	1.3
Partial AVSD Type OP ASD + Important insufficiency of LAVV	5	1.3
Total AVSD + Fixed PH	5	1.3
PFO	5	1.3
TA IA	4	1.1
VSD + PIVS	4	1.1
ASD + VSD	3	0.8
Partial AVSD Type OP ASD + PPM	3	0.8
Supravalvular Aortic Stenosis	3	0.8
Single Atrium	2	0.5
ASD + VSD + Fixed PH	2	0.5
OS ASD + Fixed PH	2	0.5
OS ASD without repercussion	2	0.5
Unbalanced Total AVSD	2	0.5
Discrete Membranous Subaortic Stenosis	2	0.5
PDA + Subaortic membrane	2	0.5
d-TGA + VSD + Pulmonary stenosis	2	0.5
ccTGA	2	0.5
ccTGA + AV Block	2	0.5
Left SV without PS	2	0.5
TA IIB	1	0.3
ASD + VSD + PDA	1	0.3
ASD + VSD + Situs Inversus + Dextrocardia	1	0.3
ASD + VSD + PIVS	1	0.3
OS ASD + Non-obstructive cor triatriatum sinistrum	1	0.3
OS ASD + PIVS	1	0.3
OS ASD + Partially Occluded VSD + PIVS	1	0.3
TAPVR + OS ASD + PDA	1	0.3
VSD + Pulmonary Atresia + Collateral S-P	1	0.3
VSD + Subaortic membrance + PIVS	1	0.3
Ascending aortic dilation + AR	1	0.3
Non-Ebstein Tricuspid Valve Dysplasia	1	0.3
Partial AVSD Type OP ASD + Situs Inversus + Dextrocardia	1	0.3
Partial AVSD Type Inlet VSD + PPM	1	0.3
Total AVSD + PIVS	1	0.3
DORV + PIVS	1	0.3
PIVS	1	0.3
PDA + Fixed PH	1	0.3
PDA + Non-compaction Cardiomyopathy	1	0.3
MVP + Ascending Aortic Ectasia + Marfan syndrome	1	0.3
ccTGA + Supravalvular PS	1	0.3
ccTGA + VSD + PVS	1	0.3
ccTGA + Dextrocardia with Situs Solitus	1	0.3
ccTGA + Dextrocardia with Situs Inversus	1	0.3
Truncus Arteriosus Type IV	1	0.3
AV Block + Moderate to Important AR	1	0.3
AV Block + Subaortic membrane + Post-stenotic ectasia	1	0.3
Right SV without PS	1	0.3
Right SV + DORV + PIVS	1	0.3
Left SV + Fixed PH	1	0.3
TOTAL	371	100

Variables					N	%
Type of heart disease
				N = 371
	Acyanogenic				249	67,1
			Normoflux		62	24,9
			Hypoflux		49	19,7
			Hyperflux		138	55,4


	Cyanogenic				122	32,9
			Normoflux		8	6,5
			Hypoflux		106	87,0
			Hyperflux		8	6,5
Clinical Classification
				N = 367
	Surgically Cured				89	24.2
	Surgically Corrected				194	52.8
	Surgically Palliative				19	5.1
	Clinical				36	9,8
	Inoperable				22	6,0
	Awaiting surgery				7	2.1
Type of Procedure Performed

	Interventional Catheterization				30	8.2
	Surgery				317	86,8
	Interventional Catheterization + Surgery				18	4,9
Functional Capacity				N = 287
	I				185	64,5
	II				100	34,8
	III				2	0,7
Pregnancies				N = 296	69	23,3


	Men				19	27,5
	Women				50	72,5
		Healthy Births			43	86,0
		Borths with CHD or Stillborns			7	14,0
Pulmonary Hypertension				N = 371	17	4.6
Acquired Co-morbidities
	SAH			N = 289	44	15,2
	Hypercholesterolemia			N = 246	39	15.8
	Hypothyroidism			N = 208	14	6,7
	Diabetes Mellitus			N = 252	10	4,0
					Mediana (IQR)
Age at Diagnosis (months)					12 (1 -120)

Age at surgery (months)					96 (38.5 – 161)

Post-operative period (years)					16 (12 – 20,25)
Diagnosis-Surgery Interval (months)					36 (12 – 84)

Clinical Group	N
VSD without repercussions	13
Ebstein's anomaly	3
Mild PVS	6
ASD without repercussions	5
ccTGA	5
PFO	2
Non-Ebstein dysplasia of the tricuspid valve	1
Ascending aortic ectasia + MVP	1
Total	36

Clinical Group Awaiting Surgery	N
Partial AVSD Type OP ASD + Important Insufficiency of LAVV	1
OS ASD + TV Dysplasia	1
VSD + AR	1
PDA	2
T4F	2
AV Block + Important AR	1
Total	8

Cirurgias	N	%
Total Correction of T4F	87	27.4
Atrial Septoplasty	41	12.9
Blalock-Taussig Surgery	17	5.4
Correction of Partial AVSD Type ASD Ostium Primum	15	4.7
Ventriculoseptoplasty	15	4.7
Correction of Total AVSD	8	2.5
Bidirectional Glenn Surgery	7	2.2
Correction of PDA	7	2.2
Senning Surgery	6	1.9
Fontan Surgery	5	1.6
Atrial septoplasty + Tricuspid Valve Repair	4	1.3
Pulmonary Artery Banding	4	1.3
ASD + VSD Correction	4	1.3
Sinus Venosus ASD Correction + TAPVR	4	1.3
Aortic Coarctation Correction + Ductus Arteriosus Closure	4	1.3
Aortic Coarctation Correction	3	0.9
Total T4F Correction + Total AVSD	3	0.9
Total T4F Correction + Ring Enlargement + Stentless L-Hydro Pulmonary Prosthesis	3	0.9
Total T4F Correction with RVOT Enlargement + Pulmonary Bioprosthesis	3	0.9
Ventriculoseptoplasty + Subaortic Membrane Resection	3	0.9
Bentall-de Bono Surgery + Aortic Valve Bioprosthesis	3	0.9
Fontan-Kreutzer Surgery	2	0.6
Jatene Surgery	2	0.6
Cone Surgery	2	0.6
Supravalvular Aortic Stenosis Correction	2	0.6
LAVV Metallic Prosthesis	2	0.6
Ventriculoseptoplasty + Pulmonary Infundibulectomy	2	0.6
Ventriculoseptoplasty + Aortic Valve Repair	2	0.6
Ventriculoseptoplasty + Mitral Valve Repair	2	0.6
Ventriculoseptoplasty + PDA Correction + Anomalous Band Resection in RVOT	2	0.6
Biological Prosthesis in Tricuspid Valve	2	0.6
Atrial Septoplasty + Metallic Prosthesis in PV	1	0.3
Atrial Septoplasty + RVOT Enlargement	1	0.3
Atrial Septoplasty + Pulmonary Commissurotomy	1	0.3
Atrial Septoplasty + Supravalvular Pulmonary Stenosis Correction	1	0.3
Atrial Septoplasty + ADPV correction + Arterial Ductus closure	1	0.3
Atrial Septoplasty + Pulmonary Vein Redirection to the Left Atrium	1	0.3
Pulmonary Artery Bandaging + Ductus Arteriosus Closure	1	0.3
Blalock-Taussig Surgery + Unifocalization of the Pulmonary Trunk	1	0.3
Bicaval Glenn Surgery	1	0.3
Bidirectional Glenn Surgery + Blalock-Taussig	1	0.3
Bidirectional Glenn Surgery + PLSVC Ligation	1	0.3
Bidirectional Glenn Surgery + Central Shunt Resection + LPA Enlargement	1	0.3
Rastelli Surgery	1	0.3
RV-PA Tube Exchange Surgery	1	0.3
Waterston-Cooley Surgery	1	0.3
Pulmonary Valve Commissurotomy	1	0.3
Correction of ASD + VSD + Closure of the Arterial Duct	1	0.3
Correction of ASD + VSD + Pulmonary Infundibulectomy	1	0.3
Correction of Aortic Coarctation + Aortic and Mitral Valve Repair + Excision of the Supra-Valvar Membrane	1	0.3
Correction of Aortic Coarctation + Resection of the Subaortic Membrane	1	0.3
Correction of Aortic Coarctation with Dacron Tube LS-Descending Aorta	1	0.3
Correction of Aortic Coarctation + Unifocalization of the Left Pulmonary Artery	1	0.3
Correction of Partial AVSD Type ASD Ostium Primum + Correction of Aortic Coarctation	1	0.3
Correction of Partial AVSD Type ASD Ostium Primum + Metallic LAVV Prosthesis	1	0.3
Correction of Partial AVSD Type Single Atrium + LAVV Repair	1	0.3
Correction of Partial AVSD Type Single Atrium	1	0.3
Correction of Partial AVSD Type Outlet VSD Via Entry	1	0.3
Complete AVSD Correction + Atrial Septoplasty	1	0.3
Correction of DORV	1	0.3
Correction of PFO	1	0.3
Total Correction of T4F + Atrial Septoplasty + Closure of the Arterial Ductus	1	0.3
Pulmonary Infundibulectomy	1	0.3
RV Infundibulectomy + Pulmonary Commissurotomy	1	0.3
Tricuspid Valve Repair	1	0.3
LAVV Repair	1	0.3
Subaortic Membrane Resection + Aortic Valve Repair	1	0.3
Supravalvular Aortic Membrane Resection + Correction of TAPVR	1	0.3
Biological Prosthesis in Aortic Valve	1	0.3
Metallic Aortic Valve Prosthesis	1	0.3
Subvalvular Aortic Fibrous Ring Resection	1	0.3
Subaortic Membrane Resection	1	0.3
Ventriculoseptoplasty + RVOT Enlargement	1	0.3
Ventriculoseptoplasty + PAB Takedown	1	0.3
Ventriculoseptoplasty + PFO Closure	1	0.3
Ventriculoseptoplasty + Pulmonary Commissurotomy	1	0.3
Ventriculoseptoplasty + Pulmonary Valve Repair	1	0.3
Ventriculoseptoplasty + Mitral Cleft Repair	1	0.3
Ventriculoseptoplasty + Stentless Pulmonary Bioprosthesis 19	1	0.3
Ventriculoseptoplasty + Metallic Aortic Prosthesis	1	0.3
Ventriculoseptoplasty + Resection of Subvalvular Aortic Fibrous Ring	1	0.3
Ventriculoseptoplasty + Subaortic Membrane Resection + Resection of Fibrosis in the RVOT	1	0.3
	317	100%

Interventional Catheterization + Surgery	N
Total Correction of T4F + Pulmonary Valvuloplasty	5
Aortic Angioplasty + Surgical Correction of Aortic Coarctation	2
Atrial Septostomy + Senning Surgery	2
Total Correction of T4F + PA Angioplasty with Palmaz Stent	1
DORV Repair + PIVS + Percutaneous Closure of PDA	1
Fontan Surgery + Plug Implantation for AV and VV Fistula Closure + Amplatzer Prosthesis for Fenestration Closure	1
Pulmonary Valvuloplasty + Bidirectional Glenn Shunt + Outlet RV Enlargement	1
PDA Closure with Plug + PDA Correction with Device Removal	1
Correction of Ostium Primum ASD + Aortoplasty with Stent	1
Pulmonary Commissurotomy + Pulmonary Valvuloplasty	1
Right Ventricular Infundibulectomy with Pulmonary Commissurotomy + Pulmonary Valvuloplasty + Atrial Septoplasty	1
Surgery of Blalock-Taussig + Pulmonary Valvuloplasty	1
Total	18

BMI	N = 169	SAH	p-value
Kg/m²	N (%)	N (%)	p-value
< 18.5	23 (13.6)	1 (4.3)	0.12
18.5 - 24.9	98 (58.0)	16 (16.5)	0.34
25.0 - 29.9	37 (21.9)	17 (45.9)	0.01
≥ 30.0	11 (6.5)	8 (72.7)	<0.001

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[TFN1] TAPVR: Total Anomalous Pulmonary Venous Connection; PIVS: pulmonary infundibulovalvar stenosis; LAVV: left atrioventricular valve; SV ASD: Sinus Venosus Atrial Septal Defect; ASD: atrial septal defect; VSD: ventricular septal defect; PVS: pulmonary valve stenosis; PDA: Patent Ductus Arteriosus, T4F: tetralogy of Fallot; AVSD: Atrioventricular Septal Defect; OS: Ostium Secundun; AR: Aortic Regurgitation; OP: Ostium Primum; PPM: Permanent Pacemaker; PM: Pacemaker; TA: Tricuspid Atresia; DORV: Double Outlet Right Ventricle; PH: Pulmonary Hypertension; MVP: Mitral Valve Prolapse; TGA: Transposition of the Great Arteries; ccTGA: Congenitally Corrected Transposition of the Great Arteries; SV: Sinus Venous; PFO: Patent Foramen Ovale; TA: Tricuspid Atresia; AV Block: Atrioventricular Block; AR: Aortic Regurgitation; SV: Single Ventricle; PM: Perimembranous; d-TGA: Dextro-Transposition of the Great Arteries; AV Block: Atrioventricular Block; PS: Pulmonary Stenosis.